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v1.0.0
ICD-10 Guide
ICD-10 CodesZ38.7

Z38.7

Other multiple liveborn infant, born outside hospital

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

Code Description

ICD-10 Z38.7 is a billable code used to indicate a diagnosis of other multiple liveborn infant, born outside hospital.

Key Diagnostic Point:

Z38.7 is used to classify multiple liveborn infants who are delivered outside of a hospital setting. This code is significant in understanding the health status of these infants, as they may face unique challenges compared to those born in a hospital. Factors influencing their health include access to prenatal care, maternal health, and socioeconomic conditions. Preventive care for these infants may involve early screenings for congenital conditions, immunizations, and regular follow-ups to monitor growth and development. Social determinants such as housing stability, access to healthcare services, and maternal education play a crucial role in the health outcomes of these infants. Coders must ensure accurate documentation of the circumstances surrounding the birth and any subsequent healthcare services provided to these infants to facilitate appropriate care and resource allocation.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Documentation of birth circumstances (home vs. hospital)
  • Variability in care needs for multiple liveborn infants
  • Potential for co-morbid conditions requiring additional coding
  • Need for comprehensive follow-up care documentation

Audit Risk Factors

  • Inadequate documentation of the birth setting
  • Failure to capture all liveborn infants in multiple births
  • Lack of follow-up care documentation
  • Misclassification of the birth setting (home vs. hospital)

Specialty Focus

Medical Specialties

Primary Care

Documentation Requirements

Documentation should include prenatal care history, delivery details, and follow-up care plans.

Common Clinical Scenarios

Routine checkups for multiple infants, screenings for developmental milestones, and immunization schedules.

Billing Considerations

Consideration of social determinants such as family support, access to healthcare, and maternal education.

Public Health

Documentation Requirements

Population-level data collection, including birth outcomes and health service utilization.

Common Clinical Scenarios

Epidemiological studies on the health of infants born outside hospitals and preventive health initiatives.

Billing Considerations

Focus on tracking health disparities and access to care for families in various socioeconomic conditions.

Coding Guidelines

Inclusion Criteria

Use Z38.7 When
  • Z codes are used to indicate factors influencing health status and contact with health services
  • When coding Z38
  • 7, ensure it is sequenced appropriately, typically following any acute conditions or complications
  • Payer requirements may vary, so confirm with specific insurance guidelines regarding the use of Z codes

Exclusion Criteria

Do NOT use Z38.7 When
No specific exclusions found.

Related CPT Codes

99381CPT Code

Initial preventive medicine visit, infant

Clinical Scenario

Used for the first preventive visit for a multiple liveborn infant.

Documentation Requirements

Document growth parameters, developmental milestones, and family history.

Specialty Considerations

Primary care providers should assess social determinants impacting health.

90460CPT Code

Immunization administration

Clinical Scenario

Administering vaccines to multiple liveborn infants during follow-up visits.

Documentation Requirements

Record immunization history and parental consent.

Specialty Considerations

Consider the need for education on vaccine schedules.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for greater specificity in coding multiple liveborn infants, enhancing the ability to track health outcomes and resource needs for this population.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for greater specificity in coding multiple liveborn infants, enhancing the ability to track health outcomes and resource needs for this population.

Reimbursement & Billing Impact

reimbursement.

Resources

Clinical References

  • •
    CDC Immunization Schedule
  • •
    Healthy People 2030: Maternal, Infant, and Child Health

Coding & Billing References

  • •
    CDC Immunization Schedule
  • •
    Healthy People 2030: Maternal, Infant, and Child Health

Frequently Asked Questions

What are the key considerations when coding for infants born outside of a hospital?

Key considerations include documenting the birth setting, ensuring all infants in a multiple birth are accounted for, and understanding the social determinants that may impact their health outcomes.