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ICD-10 Guide
ICD-10 CodesChapter 16: Certain conditions originating in the perinatal periodP61

P61

Non-billable

Other perinatal hematological disorders

Chapter 16:Certain conditions originating in the perinatal period

BILLABLE STATUSNo
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/05/2025

Code Description

ICD-10 P61 is a used to indicate a diagnosis of other perinatal hematological disorders.

Key Diagnostic Point:

The ICD-10 Level 1 Category code P61 pertains to 'Other perinatal hematological disorders,' which encompasses a variety of hematological conditions that may arise during the perinatal period, specifically affecting newborns. This category includes disorders such as neonatal anemia, thrombocytopenia, and other blood-related issues that are not classified under more specific codes. These conditions can have significant implications for the health of the newborn, necessitating careful monitoring and management to prevent complications such as increased risk of infection, bleeding, or developmental delays. Clinicians must be aware of the various hematological disorders that can occur in the perinatal period to provide timely and effective care.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of conditions covered
  • Need for clinical correlation
  • Potential for overlapping diagnoses

Audit Risk Factors

  • Inadequate documentation of specific conditions
  • Misclassification of hematological disorders
  • Failure to capture all relevant clinical details

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Hematology

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Related CPT Codes

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The clinical impact of the P61 code category is significant, as it addresses conditions that can affect newborn health outcomes. Proper coding and management of these hematological disorders can lead to improved quality measures, such as reduced rates of complications and better overall health for affected infants. Administratively, accurate coding is essential for tracking healthcare trends related to perinatal health, informing population health strategies, and guiding resource allocation to support affected populations.

ICD-9 vs ICD-10

The clinical impact of the P61 code category is significant, as it addresses conditions that can affect newborn health outcomes. Proper coding and management of these hematological disorders can lead to improved quality measures, such as reduced rates of complications and better overall health for affected infants. Administratively, accurate coding is essential for tracking healthcare trends related to perinatal health, informing population health strategies, and guiding resource allocation to support affected populations.

Reimbursement & Billing Impact

Reimbursement may vary based on the severity of the condition and the complexity of the care provided, so it is crucial to align coding with clinical documentation to support claims. Additionally, familiarity with payer-specific guidelines can help optimize reimbursement and reduce the risk of claim denials.

Resources

Clinical References

  • •
    Official ICD-10 Guidelines for P61

Coding & Billing References

  • •
    Official ICD-10 Guidelines for P61

Frequently Asked Questions

What conditions are included in P61?

P61 includes a range of hematological disorders that occur in the perinatal period, such as neonatal anemia, thrombocytopenia, and other unspecified blood disorders affecting newborns.

When should I use P61 codes?

P61 codes should be used when a newborn presents with hematological disorders that do not fall under more specific codes, particularly when these conditions are identified during the perinatal period.

What documentation is required for P61?

Documentation should include clinical findings, laboratory results, and any treatment provided for the hematological disorder, ensuring that the specific condition is clearly identified and justified.