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ICD-10 Guide
ICD-10 CodesZ38.64

Z38.64

Quadruplet liveborn infant, delivered by cesarean

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

Code Description

ICD-10 Z38.64 is a billable code used to indicate a diagnosis of quadruplet liveborn infant, delivered by cesarean.

Key Diagnostic Point:

Z38.64 is used to classify a liveborn infant who is part of a quadruplet birth and was delivered via cesarean section. This code is essential for capturing the complexities associated with multiple births, particularly in terms of maternal and infant health outcomes. Factors influencing health status include maternal age, prenatal care access, socioeconomic status, and the presence of any complications during pregnancy or delivery. Preventive care for these infants may involve early screenings for developmental milestones and health assessments to monitor growth and potential health issues. Social determinants such as family support, housing stability, and access to healthcare services play a critical role in the aftercare and long-term health of both the infant and the family. Proper documentation is crucial to ensure accurate coding and to facilitate appropriate care and resource allocation.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Multiple birth complexities requiring detailed documentation
  • Potential for associated complications during delivery
  • Need for comprehensive aftercare planning
  • Variability in healthcare access and social determinants

Audit Risk Factors

  • Inadequate documentation of the delivery method
  • Failure to capture associated maternal conditions
  • Misclassification of birth order or type
  • Lack of follow-up care documentation

Specialty Focus

Medical Specialties

Primary Care

Documentation Requirements

Documentation should include prenatal care history, delivery details, and aftercare plans. Routine checkups should be documented with growth assessments and developmental screenings.

Common Clinical Scenarios

Routine checkups for the infant, screenings for developmental milestones, and aftercare visits to monitor health status.

Billing Considerations

Consideration of social determinants such as family support systems, access to healthcare, and socioeconomic factors affecting the infant's health.

Public Health

Documentation Requirements

Population-level data collection, including birth outcomes and health status tracking for multiple births.

Common Clinical Scenarios

Epidemiological studies on multiple births, preventive health initiatives targeting families with multiple infants.

Billing Considerations

Focus on health disparities and access to resources for families with quadruplets.

Coding Guidelines

Inclusion Criteria

Use Z38.64 When
  • Z codes should be used to indicate the status of a liveborn infant, particularly in the context of multiple births
  • They should be sequenced appropriately, often following the primary diagnosis related to the mother's condition or the delivery
  • Payer requirements may vary, so it's essential to verify specific guidelines

Exclusion Criteria

Do NOT use Z38.64 When
No specific exclusions found.

Related CPT Codes

99391CPT Code

Preventive medicine visit, infant

Clinical Scenario

Used for routine checkups for quadruplet infants.

Documentation Requirements

Documentation of growth assessments, developmental screenings, and parental education.

Specialty Considerations

Primary care providers should focus on comprehensive care plans for 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 data accuracy and facilitating better healthcare planning and resource allocation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for greater specificity in coding multiple births, improving data accuracy and facilitating better healthcare planning and resource allocation.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for greater specificity in coding multiple births, improving data accuracy and facilitating better healthcare planning and resource allocation.

Resources

Clinical References

  • •
    CDC Guidelines on Multiple Births

Coding & Billing References

  • •
    CDC Guidelines on Multiple Births

Frequently Asked Questions

What documentation is required for coding Z38.64?

Documentation must include details of the delivery method, the number of infants, any maternal health conditions, and follow-up care plans. It's essential to capture all relevant information to support the coding of multiple births.