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v1.0.0
ICD-10 Guide
ICD-10 CodesP25.0

P25.0

Billable

Interstitial emphysema originating in the perinatal period

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

Code Description

ICD-10 P25.0 is a billable code used to indicate a diagnosis of interstitial emphysema originating in the perinatal period.

Key Diagnostic Point:

Interstitial emphysema is a condition characterized by the presence of air in the interstitial spaces of the lungs, which can occur in newborns, particularly those who are premature or have experienced trauma during delivery. This condition is often associated with mechanical ventilation, where barotrauma or volutrauma can lead to the rupture of alveoli, allowing air to escape into the surrounding lung tissue. In the perinatal period, interstitial emphysema can manifest as respiratory distress, decreased oxygen saturation, and abnormal lung sounds. Diagnosis typically involves imaging studies such as chest X-rays, which may reveal hyperinflation and air trapping. Management focuses on supportive care, including oxygen therapy and, in severe cases, mechanical ventilation adjustments. Understanding the etiology and clinical presentation of interstitial emphysema is crucial for effective treatment and coding, as it can significantly impact the newborn's respiratory status and overall health outcomes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation among newborns
  • Need for precise documentation of respiratory support methods
  • Differentiation from other respiratory conditions
  • Potential for co-morbidities affecting coding

Audit Risk Factors

  • Inadequate documentation of respiratory support
  • Failure to specify the cause of interstitial emphysema
  • Misclassification with other respiratory diagnoses
  • Lack of clarity in the clinical narrative

Specialty Focus

Medical Specialties

Neonatology

Documentation Requirements

Detailed records of respiratory assessments, interventions, and outcomes are essential. Documentation should include the type of respiratory support provided and any complications encountered.

Common Clinical Scenarios

Common scenarios include premature infants requiring mechanical ventilation, infants with congenital anomalies affecting lung development, and those with birth asphyxia.

Billing Considerations

Neonatologists must ensure that all aspects of care, including the timing and nature of interventions, are thoroughly documented to support accurate coding.

Pediatrics

Documentation Requirements

Pediatric documentation should include a comprehensive history of the newborn's respiratory status and any interventions taken post-discharge.

Common Clinical Scenarios

Pediatricians may encounter cases of interstitial emphysema in follow-up visits, particularly in infants with a history of respiratory distress.

Billing Considerations

Pediatric coders should be aware of the long-term implications of interstitial emphysema and ensure that follow-up care is accurately documented.

Coding Guidelines

Inclusion Criteria

Use P25.0 When
  • Perinatal coding guidelines emphasize the importance of specificity in documenting the cause and nature of respiratory conditions
  • Coders should refer to the ICD
  • CM guidelines for coding respiratory conditions in newborns, ensuring that all relevant details are captured

Exclusion Criteria

Do NOT use P25.0 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

94660CPT Code

Continuous positive airway pressure (CPAP) ventilation

Clinical Scenario

Used in the management of interstitial emphysema in preterm infants.

Documentation Requirements

Document the indication for CPAP and the infant's response to treatment.

Specialty Considerations

Neonatologists should ensure that the rationale for CPAP use is clearly articulated in the medical record.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of neonatal conditions, including interstitial emphysema. This specificity improves data accuracy and enhances the ability to track outcomes and resource utilization in neonatal care.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of neonatal conditions, including interstitial emphysema. This specificity improves data accuracy and enhances the ability to track outcomes and resource utilization in neonatal care.

Reimbursement & Billing Impact

reimbursement and compliance.

Resources

Clinical References

  • •
    American Academy of Pediatrics - Neonatal Coding Guidelines

Coding & Billing References

  • •
    American Academy of Pediatrics - Neonatal Coding Guidelines

Frequently Asked Questions

What are the common causes of interstitial emphysema in newborns?

Common causes include mechanical ventilation, barotrauma, and volutrauma, particularly in premature infants or those with respiratory distress.