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ICD-10 Guide
ICD-10 CodesP36.39

P36.39

Billable

Sepsis of newborn due to other staphylococci

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

Code Description

ICD-10 P36.39 is a billable code used to indicate a diagnosis of sepsis of newborn due to other 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 P36.39, the sepsis is specifically attributed to other staphylococci, excluding Staphylococcus aureus. Newborns are particularly vulnerable to infections due to their immature immune systems. Common pathogens include Group B Streptococcus (GBS) and Escherichia coli (E. coli), but other staphylococci can also cause significant morbidity. Clinical manifestations of sepsis in neonates may include lethargy, poor feeding, temperature instability, and respiratory distress. Diagnosis typically involves blood cultures, clinical evaluation, and laboratory tests. Early recognition and treatment are crucial, as sepsis can rapidly progress to severe illness or death. Management often includes intravenous antibiotics, supportive care, and monitoring in a neonatal intensive care unit (NICU). Understanding the specific causative organism is essential for guiding appropriate antibiotic therapy and improving outcomes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between various bacterial pathogens causing sepsis.
  • Understanding the clinical presentation and diagnostic criteria for sepsis in neonates.
  • Navigating the nuances of coding for sepsis versus other infections.
  • Documenting the severity and timing of the infection accurately.

Audit Risk Factors

  • Inadequate documentation of the causative organism.
  • Failure to document clinical signs and symptoms of sepsis.
  • Incorrect coding of sepsis severity.
  • Lack of follow-up documentation on treatment response.

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, poor feeding, and temperature instability in the NICU.

Billing Considerations

Ensure that all clinical findings are documented to support the diagnosis of sepsis and its causative agent.

Pediatrics

Documentation Requirements

Comprehensive history and physical examination findings, including maternal history and delivery details.

Common Clinical Scenarios

Pediatric follow-up visits for infants discharged from the NICU with a history of sepsis.

Billing Considerations

Consider the long-term implications of sepsis on development and health outcomes.

Coding Guidelines

Inclusion Criteria

Use P36.39 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the diagnosis is supported by clinical documentation
  • Specific criteria for sepsis must be met, including the presence of infection and systemic inflammatory response

Exclusion Criteria

Do NOT use P36.39 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.

Documentation Requirements

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

Specialty Considerations

Neonatologists must 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 greater specificity in coding neonatal sepsis, enabling better tracking of outcomes and resource utilization. This has implications for quality reporting and reimbursement.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for greater specificity in coding neonatal sepsis, enabling better tracking of outcomes and resource utilization. This has implications for quality reporting and reimbursement.

Reimbursement & Billing Impact

reimbursement.

Resources

Clinical References

  • •
    CDC Guidelines for the Prevention of Perinatal Group B Streptococcal Disease

Coding & Billing References

  • •
    CDC Guidelines for the Prevention of Perinatal Group B Streptococcal Disease

Frequently Asked Questions

What are the common signs of sepsis in newborns?

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