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v1.0.0
ICD-10 Guide
ICD-10 CodesP83.81

P83.81

Billable

Umbilical granuloma

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

Code Description

ICD-10 P83.81 is a billable code used to indicate a diagnosis of umbilical granuloma.

Key Diagnostic Point:

Umbilical granuloma is a common condition observed in newborns, characterized by the formation of a small, benign growth at the site of the umbilical cord stump after it has fallen off. This condition typically arises due to incomplete healing of the umbilical cord area, leading to an overgrowth of granulation tissue. Clinically, umbilical granulomas appear as small, reddish-brown nodules that may be moist or dry and can sometimes be associated with mild discharge. While they are generally harmless, they can become a source of irritation or infection if not properly managed. Treatment often involves the application of topical agents or, in some cases, surgical excision. It is essential for healthcare providers to monitor the umbilical area for signs of infection or other complications, ensuring that the granuloma does not interfere with the overall health of the newborn. Proper documentation and coding are crucial for accurate billing and to reflect the clinical management of this condition.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation and treatment options
  • Potential for misdiagnosis with other umbilical conditions
  • Need for detailed documentation of treatment and follow-up
  • Variations in coding practices across different healthcare settings

Audit Risk Factors

  • Inadequate documentation of clinical findings
  • Failure to specify treatment provided
  • Misclassification of umbilical conditions
  • Lack of follow-up notes on the condition's resolution

Specialty Focus

Medical Specialties

Neonatology

Documentation Requirements

Neonatologists must document the size, appearance, and any associated symptoms of the umbilical granuloma, as well as the treatment plan and follow-up care.

Common Clinical Scenarios

Common scenarios include a newborn presenting with a granuloma during routine check-ups or after the umbilical stump has fallen off.

Billing Considerations

Neonatologists should be aware of the potential for infection and the need for timely intervention if the granuloma does not resolve.

Pediatrics

Documentation Requirements

Pediatricians should document the history of the umbilical granuloma, including any parental concerns and the response to treatment.

Common Clinical Scenarios

Pediatric visits may involve follow-up assessments of the granuloma and discussions with parents about care and management.

Billing Considerations

Pediatricians should consider the psychosocial aspects of parental anxiety regarding the granuloma and provide reassurance.

Coding Guidelines

Inclusion Criteria

Use P83.81 When
  • 10 coding guidelines for P83
  • 81 require specificity in documenting the condition, including any associated symptoms or treatments
  • Coders should ensure that the diagnosis is supported by clinical documentation

Exclusion Criteria

Do NOT use P83.81 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

12001CPT Code

Simple repair of superficial wound

Clinical Scenario

Used when surgical excision of the granuloma is performed.

Documentation Requirements

Document the size of the granuloma and the method of excision.

Specialty Considerations

Neonatologists should ensure that the procedure is justified based on clinical findings.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of conditions like umbilical granuloma, improving the accuracy of diagnoses and treatment documentation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like umbilical granuloma, improving the accuracy of diagnoses and treatment documentation.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of conditions like umbilical granuloma, improving the accuracy of diagnoses and treatment documentation.

Resources

Clinical References

  • •
    American Academy of Pediatrics Guidelines

Coding & Billing References

  • •
    American Academy of Pediatrics Guidelines

Frequently Asked Questions

What is the typical treatment for umbilical granuloma?

Treatment for umbilical granuloma often involves the application of topical agents such as silver nitrate or, in some cases, surgical excision if the granuloma is persistent or symptomatic.