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v1.0.0
ICD-10 Guide
ICD-10 CodesP74.42

P74.42

Billable

Disturbances of chlorine balance of newborn

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

Code Description

ICD-10 P74.42 is a billable code used to indicate a diagnosis of disturbances of chlorine balance of newborn.

Key Diagnostic Point:

Disturbances of chlorine balance in newborns can manifest as either hyperchloremia or hypochloremia, which may arise from various underlying conditions such as dehydration, renal dysfunction, or metabolic disorders. These imbalances can lead to significant clinical implications, including altered acid-base status and potential respiratory or metabolic complications. Newborns are particularly vulnerable due to their immature renal function and fluid balance regulation. Clinicians must monitor electrolyte levels closely, especially in preterm infants or those with underlying health issues. Treatment typically involves correcting the underlying cause and restoring electrolyte balance through appropriate fluid management and electrolyte supplementation. Accurate coding of these conditions is essential for proper management and reimbursement, as well as for tracking outcomes in neonatal care.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation of electrolyte disturbances
  • Need for precise laboratory values to support diagnosis
  • Differentiation from other metabolic disturbances
  • Documentation of underlying causes and treatment plans

Audit Risk Factors

  • Inadequate documentation of laboratory results
  • Failure to specify the type of disturbance (hyper or hypochloremia)
  • Lack of clarity on underlying conditions
  • Inconsistent coding of related metabolic disorders

Specialty Focus

Medical Specialties

Neonatology

Documentation Requirements

Detailed records of electrolyte levels, clinical signs, and treatment protocols are essential.

Common Clinical Scenarios

Neonates in the NICU with dehydration or renal impairment requiring electrolyte monitoring.

Billing Considerations

Consideration of gestational age and birth weight, as these factors influence electrolyte management.

Pediatrics

Documentation Requirements

Documentation should include growth parameters and developmental assessments alongside electrolyte management.

Common Clinical Scenarios

Pediatric patients with a history of perinatal electrolyte disturbances presenting with growth issues.

Billing Considerations

Long-term follow-up may be necessary to assess developmental outcomes related to early electrolyte imbalances.

Coding Guidelines

Inclusion Criteria

Use P74.42 When
  • Follow the ICD
  • CM guidelines for coding electrolyte imbalances, ensuring that all relevant clinical information is documented to support the diagnosis

Exclusion Criteria

Do NOT use P74.42 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

36415CPT Code

Collection of venous blood by venipuncture

Clinical Scenario

Used to obtain blood samples for electrolyte analysis in newborns.

Documentation Requirements

Document the reason for blood draw and any relevant clinical findings.

Specialty Considerations

Neonatologists should ensure that the procedure is justified based on the infant's clinical status.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of electrolyte disturbances, improving the ability to track and manage these conditions in newborns.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of electrolyte disturbances, improving the ability to track and manage these conditions in newborns.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of electrolyte disturbances, improving the ability to track and manage these conditions in newborns.

Resources

Clinical References

  • •
    Neonatal Electrolyte Management Guidelines

Coding & Billing References

  • •
    Neonatal Electrolyte Management Guidelines

Frequently Asked Questions

What are the common causes of chlorine balance disturbances in newborns?

Common causes include dehydration, renal impairment, and metabolic disorders. Monitoring and management are crucial to prevent complications.