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v1.0.0
ICD-10 Guide
ICD-10 CodesP01.6

P01.6

Billable

Newborn affected by maternal death

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

Code Description

ICD-10 P01.6 is a billable code used to indicate a diagnosis of newborn affected by maternal death.

Key Diagnostic Point:

P01.6 refers to newborns who are affected by maternal death, which can occur due to various complications during pregnancy. Maternal complications such as incompetent cervix, premature rupture of membranes (PROM), and multiple pregnancies can significantly impact neonatal outcomes. Incompetent cervix may lead to preterm labor and delivery, resulting in premature infants who are at higher risk for morbidity and mortality. PROM can lead to infections and other complications that may affect the newborn's health. Multiple pregnancies often result in higher rates of complications, including preterm birth and low birth weight, which can further complicate the clinical picture. The newborn may require intensive monitoring and care in a Neonatal Intensive Care Unit (NICU) setting to address these risks. Understanding the maternal history and complications is crucial for appropriate coding and management of the newborn's health.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Variability in maternal complications leading to different neonatal outcomes
  • Need for detailed maternal history to accurately code the newborn's condition
  • Potential for multiple codes to be applicable based on maternal and neonatal conditions
  • Documentation requirements that may vary by healthcare setting

Audit Risk Factors

  • Inadequate documentation of maternal complications
  • Failure to link maternal conditions to neonatal outcomes
  • Incorrect coding of associated neonatal conditions
  • Lack of clarity in interdisciplinary notes regarding maternal history

Specialty Focus

Medical Specialties

Neonatology

Documentation Requirements

Detailed documentation of neonatal assessments, interventions, and outcomes is essential. This includes gestational age, birth weight, and any complications observed.

Common Clinical Scenarios

Common scenarios include premature infants requiring respiratory support, infants with low birth weight due to maternal complications, and those needing specialized care for infections.

Billing Considerations

Neonatologists must ensure that maternal history is clearly documented to support the coding of P01.6 and any associated conditions.

Pediatrics

Documentation Requirements

Pediatricians should document any ongoing developmental assessments and follow-up care related to the newborn's condition.

Common Clinical Scenarios

Pediatric scenarios may include follow-up visits for developmental delays or health issues stemming from maternal complications.

Billing Considerations

Pediatricians should be aware of the long-term implications of maternal complications on the child's health and development.

Coding Guidelines

Inclusion Criteria

Use P01.6 When
  • Coders should refer to the official ICD
  • CM guidelines for perinatal coding, ensuring that all relevant maternal and neonatal conditions are documented and coded accurately
  • Specific criteria for coding P01
  • 6 include the necessity of linking maternal death to the newborn's condition

Exclusion Criteria

Do NOT use P01.6 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

99460CPT Code

Initial hospital care, per day, for evaluation and management of a normal newborn infant

Clinical Scenario

Used for newborns requiring initial assessment in the NICU due to maternal death.

Documentation Requirements

Documentation of the newborn's condition, gestational age, and any interventions performed.

Specialty Considerations

Neonatologists should ensure that all assessments are documented to support billing.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of perinatal conditions, including maternal death impacts on newborns. This specificity aids in better tracking of outcomes and resource allocation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of perinatal conditions, including maternal death impacts on newborns. This specificity aids in better tracking of outcomes and resource allocation.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of perinatal conditions, including maternal death impacts on newborns. This specificity aids in better tracking of outcomes and resource allocation.

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 documentation is required to support the use of code P01.6?

To support the use of code P01.6, documentation must include a clear indication of maternal death, details of maternal complications during pregnancy, and the newborn's clinical status at birth. This includes gestational age, birth weight, and any immediate health concerns.