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v1.0.0
ICD-10 Guide
ICD-10 CodesP05.17

P05.17

Billable

Newborn small for gestational age, 1750-1999 grams

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

Code Description

ICD-10 P05.17 is a billable code used to indicate a diagnosis of newborn small for gestational age, 1750-1999 grams.

Key Diagnostic Point:

Newborns classified as small for gestational age (SGA) are those whose birth weight is below the 10th percentile for their gestational age. Specifically, P05.17 refers to infants weighing between 1750 and 1999 grams at birth. This condition can arise from various maternal factors, including inadequate maternal nutrition, placental insufficiency, or maternal health issues such as hypertension or diabetes. Delivery complications, such as preterm birth or intrauterine growth restriction (IUGR), can also contribute to SGA status. These infants are at increased risk for perinatal morbidity and mortality, necessitating careful monitoring and management in the neonatal period. Clinical assessment often includes evaluating growth parameters, feeding tolerance, and potential complications such as hypoglycemia or respiratory distress. Early identification and intervention are crucial to improve outcomes for these vulnerable newborns.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in gestational age assessment
  • Differentiation between SGA and IUGR
  • Maternal health history documentation
  • Potential for co-morbid conditions

Audit Risk Factors

  • Inaccurate gestational age documentation
  • Failure to document maternal factors
  • Misclassification of SGA versus IUGR
  • Omission of relevant neonatal assessments

Specialty Focus

Medical Specialties

Neonatology

Documentation Requirements

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

Common Clinical Scenarios

Management of SGA infants in the NICU, including feeding challenges and monitoring for hypoglycemia.

Billing Considerations

Consideration of maternal health factors and their impact on neonatal outcomes.

Pediatrics

Documentation Requirements

Comprehensive history of prenatal care and maternal health, along with growth monitoring post-discharge.

Common Clinical Scenarios

Follow-up care for SGA infants, including developmental assessments and nutritional support.

Billing Considerations

Awareness of long-term growth patterns and potential developmental delays.

Coding Guidelines

Inclusion Criteria

Use P05.17 When
  • 10 guidelines specify that P05
  • 17 should be used when the newborn's weight is documented between 1750
  • 1999 grams and is classified as SGA
  • Accurate gestational age and weight must be recorded to support coding

Exclusion Criteria

Do NOT use P05.17 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

Clinical Scenario

Used for initial assessment of an SGA newborn in the NICU.

Documentation Requirements

Document weight, gestational age, and any complications.

Specialty Considerations

Neonatologists should ensure comprehensive evaluations 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 SGA conditions, improving the ability to capture the nuances of neonatal care and maternal factors affecting newborns.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of SGA conditions, improving the ability to capture the nuances of neonatal care and maternal factors affecting newborns.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of SGA conditions, improving the ability to capture the nuances of neonatal care and maternal factors affecting newborns.

Resources

Clinical References

  • •
    American Academy of Pediatrics - Guidelines for Perinatal Care

Coding & Billing References

  • •
    American Academy of Pediatrics - Guidelines for Perinatal Care

Frequently Asked Questions

What factors contribute to a newborn being classified as SGA?

Factors include maternal health issues such as hypertension, diabetes, poor nutrition, and placental insufficiency. Additionally, environmental factors like smoking or substance abuse can also contribute.