ICD-10 Logo
ICDxICD-10 Medical Coding
ICD-10 Logo
ICDxICD-10 Medical Coding
ICD 10 CodesDiagnoses
ICD 10 CodesDiagnoses
ICD-10 Logo
ICDxICD-10 Medical Coding

Comprehensive ICD-10-CM code reference with AI-powered search capabilities.

© 2025 ICD Code Compass. All rights reserved.

Browse

  • All Chapters
  • All Categories
  • Diagnoses

Tools

  • AI Code Search
ICD-10-CM codes are maintained by the CDC and CMS. This tool is for reference purposes only.
v1.0.0
ICD-10 Guide
ICD-10 CodesP36.3

P36.3

Billable

Sepsis of newborn due to other and unspecified staphylococci

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

Code Description

ICD-10 P36.3 is a billable code used to indicate a diagnosis of sepsis of newborn due to other and unspecified staphylococci.

Key Diagnostic Point:

Sepsis in newborns is a critical condition characterized by a systemic inflammatory response to infection, which can lead to multi-organ dysfunction. In the case of P36.3, the sepsis is specifically attributed to other and unspecified staphylococci, which may include strains not typically identified in standard testing. Staphylococcal infections can arise from various sources, including maternal colonization during labor, skin flora, or environmental exposure. Newborns, particularly preterm infants or those with low birth weight, are at heightened risk due to their immature immune systems. Symptoms may include lethargy, poor feeding, temperature instability, and respiratory distress. Early recognition and prompt treatment with appropriate antibiotics are crucial to improve outcomes. The management of sepsis in neonates often requires a multidisciplinary approach, including neonatologists, nursing staff, and infection control specialists, to ensure comprehensive care and monitoring.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between various bacterial pathogens causing sepsis.
  • Understanding the clinical presentation and management of sepsis in neonates.
  • Navigating the nuances of maternal health history and its impact on neonatal infections.
  • Interpreting laboratory results and cultures that may not specify the organism.

Audit Risk Factors

  • Inadequate documentation of the source of infection.
  • Failure to specify the type of staphylococcus involved.
  • Misclassification of sepsis severity.
  • Lack of clear clinical indicators for the diagnosis.

Specialty Focus

Medical Specialties

Neonatology

Documentation Requirements

Detailed clinical notes on the infant's condition, including vital signs, laboratory results, and treatment plans.

Common Clinical Scenarios

Infants presenting with lethargy and temperature instability in the NICU, requiring sepsis workup.

Billing Considerations

Accurate documentation of maternal health history and potential risk factors for infection.

Pediatrics

Documentation Requirements

Comprehensive history and physical examination notes, including any follow-up care for the infant.

Common Clinical Scenarios

Pediatric follow-up visits for infants discharged after treatment for sepsis.

Billing Considerations

Consideration of long-term effects of sepsis on growth and development.

Coding Guidelines

Inclusion Criteria

Use P36.3 When
  • Coders should adhere to the official ICD
  • CM guidelines, ensuring that all documentation supports the diagnosis of sepsis and its causative organism
  • Specific criteria for neonatal sepsis must be met, including clinical signs, laboratory findings, and treatment protocols

Exclusion Criteria

Do NOT use P36.3 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

99291CPT Code

Critical care, evaluation and management of the critically ill infant or child

Clinical Scenario

Used when a newborn with sepsis requires intensive monitoring and management in the NICU.

Documentation Requirements

Detailed notes on the infant's condition, interventions, and response to treatment.

Specialty Considerations

Neonatologists should ensure that all critical care services are documented to support billing.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of neonatal sepsis, improving the ability to track and manage these conditions. P36.3 provides a distinct code for staphylococcal infections, which aids in epidemiological studies and quality improvement initiatives.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of neonatal sepsis, improving the ability to track and manage these conditions. P36.3 provides a distinct code for staphylococcal infections, which aids in epidemiological studies and quality improvement initiatives.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of neonatal sepsis, improving the ability to track and manage these conditions. P36.3 provides a distinct code for staphylococcal infections, which aids in epidemiological studies and quality improvement initiatives.

Resources

Clinical References

  • •
    CDC Guidelines for the Prevention of Infections in Neonatal Intensive Care Units

Coding & Billing References

  • •
    CDC Guidelines for the Prevention of Infections in Neonatal Intensive Care Units

Frequently Asked Questions

What are the common signs of sepsis in newborns?

Common signs include lethargy, poor feeding, temperature instability, irritability, and respiratory distress. Early identification is crucial for effective management.

How is sepsis in newborns diagnosed?

Diagnosis typically involves clinical evaluation, blood cultures, and laboratory tests to assess inflammatory markers and organ function.

What is the treatment for neonatal sepsis?

Treatment usually involves intravenous antibiotics, supportive care, and monitoring in a NICU setting, with adjustments based on culture results.