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v1.0.0
ICD-10 Guide
ICD-10 CodesZ38.6

Z38.6

Other multiple liveborn infant, born in hospital

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/12/2025

Code Description

ICD-10 Z38.6 is a billable code used to indicate a diagnosis of other multiple liveborn infant, born in hospital.

Key Diagnostic Point:

Z38.6 is used to classify other multiple liveborn infants who are born in a hospital setting. This code is essential for capturing the health status of infants born as part of a multiple birth, which can influence their immediate and long-term health outcomes. Factors influencing health status include maternal health, prenatal care access, and socioeconomic conditions. Preventive care for these infants often involves screenings for congenital conditions, developmental assessments, and vaccinations. Social determinants such as family support, housing stability, and access to healthcare services play a crucial role in the aftercare and ongoing health of these infants. Proper documentation of the birth setting, maternal health history, and any complications during delivery is vital for accurate coding and reimbursement.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Need for detailed maternal health history
  • Documentation of multiple births and their outcomes
  • Variability in aftercare requirements based on infant health status
  • Potential for complications requiring additional coding

Audit Risk Factors

  • Inadequate documentation of maternal health conditions
  • Failure to specify the number of liveborn infants
  • Misclassification of the birth setting
  • Omission of aftercare details for each infant

Specialty Focus

Medical Specialties

Primary Care

Documentation Requirements

Documentation should include preventive care measures, developmental screenings, and any referrals made for additional services.

Common Clinical Scenarios

Routine checkups for multiple infants, vaccinations, and developmental assessments.

Billing Considerations

Consideration of social determinants such as family support systems and access to healthcare resources.

Public Health

Documentation Requirements

Documentation should focus on population health metrics, tracking of multiple births, and health outcomes.

Common Clinical Scenarios

Epidemiological studies on multiple births and preventive health initiatives.

Billing Considerations

Importance of reporting on social determinants affecting health outcomes in multiple births.

Coding Guidelines

Inclusion Criteria

Use Z38.6 When
  • Z codes should be used to indicate factors influencing health status and contact with health services
  • When coding Z38
  • 6, it should be sequenced appropriately, often following the primary diagnosis related to the birth or any complications
  • Payer requirements may vary, so it is essential to verify specific guidelines

Exclusion Criteria

Do NOT use Z38.6 When
No specific exclusions found.

Related CPT Codes

99381CPT Code

Preventive medicine visit, infant

Clinical Scenario

Used for routine check-ups for multiple liveborn infants.

Documentation Requirements

Documentation of growth, development, and preventive care provided.

Specialty Considerations

Primary care considerations for managing multiple infants.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for greater specificity in coding multiple births, improving the ability to track health outcomes and resource allocation for these infants.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for greater specificity in coding multiple births, improving the ability to track health outcomes and resource allocation for these infants.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for greater specificity in coding multiple births, improving the ability to track health outcomes and resource allocation for these infants.

Resources

Clinical References

  • •
    CDC Guidelines for Preventive Care in Infants

Coding & Billing References

  • •
    CDC Guidelines for Preventive Care in Infants

Frequently Asked Questions

What documentation is required for coding Z38.6?

Documentation must include details of the birth setting, the number of liveborn infants, maternal health history, and any complications during delivery. Additionally, aftercare plans and follow-up visits should be documented to support the coding.