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ICD-10 Guide
ICD-10 CodesChapter 16: Certain conditions originating in the perinatal periodP05

P05

Billable

Disorders of newborn related to slow fetal growth and fetal malnutrition

Chapter 16:Certain conditions originating in the perinatal period

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

Code Description

ICD-10 P05 is a billable code used to indicate a diagnosis of disorders of newborn related to slow fetal growth and fetal malnutrition.

Key Diagnostic Point:

Disorders of newborn related to slow fetal growth and fetal malnutrition encompass a range of conditions that arise due to inadequate fetal growth during pregnancy, often linked to maternal factors such as nutritional deficiencies, placental insufficiency, or maternal health conditions. These disorders can lead to low birth weight, intrauterine growth restriction (IUGR), and other complications that may affect the newborn's immediate health and long-term development. Clinically, these conditions are characterized by a newborn's weight being below the 10th percentile for gestational age, and they may present with various complications including respiratory distress, hypoglycemia, and increased susceptibility to infections. The management of these conditions requires a multidisciplinary approach, including careful monitoring in the neonatal intensive care unit (NICU) and potential interventions to support growth and development. Accurate coding is essential for appropriate reimbursement and to ensure that the newborn receives the necessary care and follow-up.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation of IUGR and malnutrition
  • Need for precise gestational age documentation
  • Differentiation between congenital and acquired conditions
  • Potential overlap with other perinatal codes

Audit Risk Factors

  • Inadequate documentation of maternal health conditions
  • Failure to specify gestational age at delivery
  • Misclassification of growth restriction types
  • Lack of follow-up documentation for growth assessments

Specialty Focus

Medical Specialties

Neonatology

Documentation Requirements

Detailed records of birth weight, gestational age, and any complications during delivery.

Common Clinical Scenarios

Newborns admitted to NICU for respiratory distress due to IUGR, requiring close monitoring and interventions.

Billing Considerations

Ensure accurate tracking of growth parameters and maternal health history to support coding.

Pediatrics

Documentation Requirements

Comprehensive growth assessments and developmental milestones tracking.

Common Clinical Scenarios

Follow-up visits for infants with a history of fetal malnutrition, assessing growth and developmental outcomes.

Billing Considerations

Consider long-term implications of fetal malnutrition on pediatric health and development.

Coding Guidelines

Inclusion Criteria

Use P05 When
  • Follow the official ICD
  • CM guidelines for coding perinatal conditions, ensuring accurate documentation of gestational age, birth weight, and any maternal factors contributing to fetal growth issues

Exclusion Criteria

Do NOT use P05 When
No specific exclusions found.

Related CPT Codes

99460CPT Code

Initial hospital care for newborns

Clinical Scenario

Used for newborns admitted for monitoring due to IUGR.

Documentation Requirements

Document birth weight, gestational age, and any complications.

Specialty Considerations

Neonatologists should ensure comprehensive assessments are recorded.

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, improving the ability to capture the nuances of fetal growth disorders and their causes, which enhances data accuracy and reimbursement processes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of perinatal conditions, improving the ability to capture the nuances of fetal growth disorders and their causes, which enhances data accuracy and reimbursement processes.

Reimbursement & Billing Impact

reimbursement processes.

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 key factors to document for coding P05?

Key factors include the newborn's gestational age, birth weight, maternal health conditions, and any complications during delivery that may have contributed to slow fetal growth or malnutrition.