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ICD-10 Guide
ICD-10 CodesP14.2

P14.2

Billable

Phrenic nerve paralysis due to birth injury

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

Code Description

ICD-10 P14.2 is a billable code used to indicate a diagnosis of phrenic nerve paralysis due to birth injury.

Key Diagnostic Point:

Phrenic nerve paralysis is a condition that arises from injury to the phrenic nerve during the birthing process, often due to mechanical trauma. This nerve is crucial for diaphragm function, and its paralysis can lead to respiratory distress in newborns. Birth injuries to the peripheral nervous system, including brachial plexus injuries, can occur during difficult deliveries, particularly in cases of shoulder dystocia or excessive traction during delivery. The impact of phrenic nerve paralysis can vary, with some infants experiencing mild symptoms that resolve spontaneously, while others may require intensive respiratory support. Diagnosis typically involves clinical evaluation and may include imaging studies to assess diaphragm movement. Management strategies focus on supportive care, monitoring respiratory function, and addressing any underlying conditions that may contribute to respiratory compromise.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between various types of birth injuries
  • Understanding the implications of peripheral nerve injuries
  • Identifying associated respiratory complications
  • Navigating documentation requirements for neonatal conditions

Audit Risk Factors

  • Inadequate documentation of the birth injury mechanism
  • Failure to note associated respiratory distress
  • Misclassification of the type of nerve injury
  • Inconsistent coding of co-morbid conditions

Specialty Focus

Medical Specialties

Neonatology

Documentation Requirements

Detailed records of respiratory assessments, interventions, and outcomes are essential for accurate coding.

Common Clinical Scenarios

Infants presenting with respiratory distress in the NICU following a traumatic delivery.

Billing Considerations

Coders must ensure that all aspects of the birth injury and its impact on respiratory function are thoroughly documented.

Pediatrics

Documentation Requirements

Pediatric documentation should include developmental assessments and follow-up care related to nerve injury.

Common Clinical Scenarios

Pediatric patients with a history of phrenic nerve paralysis presenting with respiratory issues.

Billing Considerations

Consideration of long-term outcomes and potential developmental delays associated with nerve injuries.

Coding Guidelines

Inclusion Criteria

Use P14.2 When
  • Follow the official ICD
  • CM guidelines for coding perinatal conditions, ensuring accurate documentation of the birth injury and its effects on the newborn's respiratory system

Exclusion Criteria

Do NOT use P14.2 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

94640CPT Code

Continuous positive airway pressure (CPAP) therapy

Clinical Scenario

Used for infants with respiratory distress due to phrenic nerve paralysis.

Documentation Requirements

Document the need for respiratory support and the infant's response to therapy.

Specialty Considerations

Neonatologists should ensure that all respiratory interventions are clearly documented.

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 birth injuries such as phrenic nerve paralysis.

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 birth injuries such as phrenic nerve paralysis.

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 birth injuries such as phrenic nerve paralysis.

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 are the common causes of phrenic nerve paralysis in newborns?

Phrenic nerve paralysis in newborns is often caused by birth injuries, particularly during difficult deliveries involving shoulder dystocia or excessive traction. It can also occur due to direct trauma during delivery.