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v1.0.0
ICD-10 Guide
ICD-10 CodesP12.8

P12.8

Billable

Other birth injuries to scalp

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

Code Description

ICD-10 P12.8 is a billable code used to indicate a diagnosis of other birth injuries to scalp.

Key Diagnostic Point:

Birth injuries to the scalp can occur during the delivery process, often due to mechanical forces exerted on the fetal head. Caput succedaneum is characterized by a soft tissue swelling that occurs as a result of pressure during delivery, typically resolving within a few days. Cephalohematoma, on the other hand, is a collection of blood between the skull and the periosteum, which can take weeks to resolve and may lead to complications such as jaundice. A chignon is a localized swelling that can occur from the use of vacuum extraction during delivery. These conditions are generally benign but require careful monitoring and documentation to ensure proper management and coding. Accurate coding is essential for tracking outcomes and ensuring appropriate reimbursement for care provided.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between caput succedaneum and cephalohematoma
  • Variability in clinical presentation and resolution times
  • Documentation requirements for different types of birth injuries
  • Potential for associated complications requiring additional coding

Audit Risk Factors

  • Inadequate documentation of the type of birth injury
  • Failure to specify the resolution status of the injury
  • Misclassification of injuries leading to incorrect coding
  • Lack of follow-up documentation for complications

Specialty Focus

Medical Specialties

Neonatology

Documentation Requirements

Detailed notes on the type of injury, treatment provided, and follow-up care.

Common Clinical Scenarios

Management of a newborn with caput succedaneum in the NICU, monitoring for jaundice due to cephalohematoma.

Billing Considerations

Ensure accurate differentiation between types of scalp injuries for proper coding.

Pediatrics

Documentation Requirements

Documentation of any ongoing effects of birth injuries and developmental assessments.

Common Clinical Scenarios

Follow-up visits for a child with a history of cephalohematoma.

Billing Considerations

Consider the long-term implications of scalp injuries on development.

Coding Guidelines

Inclusion Criteria

Use P12.8 When
  • Follow the official ICD
  • CM guidelines for coding birth injuries, ensuring specificity in documentation to support the diagnosis
  • Include any relevant clinical findings and treatment details

Exclusion Criteria

Do NOT use P12.8 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

99460CPT Code

Initial hospital care, per day, for evaluation and management of a normal newborn

Clinical Scenario

Used when a newborn with scalp injury requires evaluation.

Documentation Requirements

Document the newborn's condition and any interventions.

Specialty Considerations

Neonatologists should ensure thorough documentation of the injury.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of birth injuries, improving the ability to track outcomes and complications associated with scalp injuries.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of birth injuries, improving the ability to track outcomes and complications associated with scalp injuries.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of birth injuries, improving the ability to track outcomes and complications associated with scalp injuries.

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 is the difference between caput succedaneum and cephalohematoma?

Caput succedaneum is a soft tissue swelling that crosses suture lines, while cephalohematoma is a collection of blood that does not cross suture lines and is confined to the periosteum.