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ICD-10 Guide
ICD-10 CodesP08.2

P08.2

Billable

Late newborn, not heavy for gestational age

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/11/2025

Code Description

ICD-10 P08.2 is a billable code used to indicate a diagnosis of late newborn, not heavy for gestational age.

Key Diagnostic Point:

P08.2 refers to a late preterm or term newborn who is not classified as heavy for gestational age (HGA). This condition is often associated with maternal factors such as inadequate prenatal care, maternal diabetes, or hypertension, which can affect fetal growth and development. Late newborns are those born between 34 weeks and 42 weeks of gestation, and those who are not heavy for gestational age typically have a birth weight below the 90th percentile for their gestational age. These infants may face various health challenges, including respiratory distress, feeding difficulties, and increased risk of infection. Proper assessment and management are crucial to ensure optimal outcomes. The clinical team must monitor these infants closely for any signs of complications and provide appropriate interventions, including nutritional support and respiratory care, as needed.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between late newborns and those with other growth-related conditions.
  • Understanding maternal health factors that contribute to the infant's condition.
  • Accurate assessment of gestational age and weight percentiles.
  • Documentation of delivery complications that may impact the newborn's health.

Audit Risk Factors

  • Inadequate documentation of maternal health factors.
  • Failure to accurately report gestational age.
  • Misclassification of birth weight percentiles.
  • Lack of clarity in delivery complication documentation.

Specialty Focus

Medical Specialties

Neonatology

Documentation Requirements

Detailed records of birth weight, gestational age, and any complications during delivery.

Common Clinical Scenarios

Infants requiring NICU admission for respiratory support or feeding difficulties.

Billing Considerations

Close monitoring for signs of infection or metabolic issues, and ensuring accurate coding of any interventions.

Pediatrics

Documentation Requirements

Comprehensive history of maternal health and delivery complications.

Common Clinical Scenarios

Follow-up visits for late newborns with feeding issues or growth concerns.

Billing Considerations

Consideration of long-term developmental outcomes and any ongoing health issues.

Coding Guidelines

Inclusion Criteria

Use P08.2 When
  • Follow the official ICD
  • CM coding guidelines for perinatal conditions, ensuring accurate documentation of gestational age, birth weight, and any maternal factors that may influence the newborn's health

Exclusion Criteria

Do NOT use P08.2 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

99460CPT Code

Initial hospital care for newborns

Clinical Scenario

Used for the initial assessment of a late newborn in the NICU.

Documentation Requirements

Documentation of birth weight, gestational age, and any complications.

Specialty Considerations

Neonatologists should ensure thorough documentation of the newborn's condition and any interventions.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of perinatal conditions, improving the ability to capture the nuances of late newborns not heavy for gestational age. This specificity aids in better tracking of outcomes and resource allocation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of perinatal conditions, improving the ability to capture the nuances of late newborns not heavy for gestational age. This specificity aids in better tracking of outcomes and resource allocation.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of perinatal conditions, improving the ability to capture the nuances of late newborns not heavy for gestational age. This specificity aids in better tracking of outcomes and resource allocation.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What factors contribute to a newborn being classified as not heavy for gestational age?

Factors include maternal health conditions such as diabetes or hypertension, inadequate prenatal care, and nutritional deficiencies during pregnancy. These factors can lead to lower birth weights despite being born at term or late preterm.