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ICD-10 Guide
ICD-10 CodesR04.81

R04.81

Acute idiopathic pulmonary hemorrhage in infants

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

Code Description

ICD-10 R04.81 is a billable code used to indicate a diagnosis of acute idiopathic pulmonary hemorrhage in infants.

Key Diagnostic Point:

Acute idiopathic pulmonary hemorrhage in infants is a rare but serious condition characterized by the sudden onset of bleeding into the lungs of otherwise healthy infants, typically occurring within the first few weeks of life. Symptoms may include respiratory distress, tachypnea, cyanosis, and hemoptysis. The etiology remains largely unknown, hence the term 'idiopathic.' Clinical findings often reveal abnormal lung sounds, decreased oxygen saturation, and may be accompanied by radiographic evidence of pulmonary infiltrates or consolidation. Laboratory findings may include anemia and elevated inflammatory markers, although these are not specific. The acute nature of this condition necessitates prompt evaluation and management to prevent significant morbidity and mortality. Diagnosis is primarily clinical, supported by imaging and laboratory tests to rule out other causes of pulmonary hemorrhage.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Lack of clear etiology complicates diagnosis.
  • Symptoms may overlap with other respiratory conditions.
  • Requires thorough documentation of clinical findings.
  • Potential for misdiagnosis with other pulmonary conditions.

Audit Risk Factors

  • Inadequate documentation of clinical findings.
  • Failure to differentiate from other respiratory conditions.
  • Misuse of the code for non-idiopathic causes.
  • Inconsistent coding practices across providers.

Specialty Focus

Medical Specialties

Internal Medicine

Documentation Requirements

Detailed history and physical examination, including respiratory assessment and any relevant lab results.

Common Clinical Scenarios

Infants presenting with acute respiratory distress and suspected pulmonary hemorrhage.

Billing Considerations

Consideration of underlying conditions that may mimic idiopathic pulmonary hemorrhage.

Emergency Medicine

Documentation Requirements

Immediate assessment of respiratory status, vital signs, and any interventions performed.

Common Clinical Scenarios

Acute presentations of respiratory distress in infants requiring urgent care.

Billing Considerations

Rapid identification and documentation of symptoms to ensure appropriate coding.

Coding Guidelines

Inclusion Criteria

Use R04.81 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the diagnosis is supported by clinical documentation and that all relevant symptoms and findings are recorded

Exclusion Criteria

Do NOT use R04.81 When
No specific exclusions found.

Related CPT Codes

94640CPT Code

Pulmonary function testing

Clinical Scenario

When assessing lung function in infants with suspected pulmonary issues.

Documentation Requirements

Document the reason for testing and the results.

Specialty Considerations

Pediatric pulmonologists may frequently use this code.

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 acute idiopathic pulmonary hemorrhage, improving data accuracy and enhancing the ability to track and analyze this rare condition.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like acute idiopathic pulmonary hemorrhage, improving data accuracy and enhancing the ability to track and analyze this rare condition.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of conditions like acute idiopathic pulmonary hemorrhage, improving data accuracy and enhancing the ability to track and analyze this rare condition.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What are the common symptoms of acute idiopathic pulmonary hemorrhage in infants?

Common symptoms include respiratory distress, tachypnea, cyanosis, and hemoptysis. Infants may present with sudden onset of these symptoms, often requiring immediate medical attention.