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ICD-10 Guide
ICD-10 CodesP07.03

P07.03

Billable

Extremely low birth weight newborn, 750-999 grams

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

Code Description

ICD-10 P07.03 is a billable code used to indicate a diagnosis of extremely low birth weight newborn, 750-999 grams.

Key Diagnostic Point:

P07.03 refers to newborns classified as extremely low birth weight (ELBW), weighing between 750 and 999 grams at birth. These infants are at significant risk for a variety of complications due to their low birth weight, including respiratory distress syndrome, intraventricular hemorrhage, and necrotizing enterocolitis. The management of ELBW infants often requires specialized neonatal intensive care, including thermal stabilization, respiratory support, and nutritional management. Maternal factors such as preeclampsia, gestational diabetes, and infections can contribute to the risk of delivering an ELBW infant. Delivery complications, including preterm labor and placental insufficiency, also play a critical role in the outcomes of these newborns. Accurate coding for P07.03 is essential for tracking outcomes and resource utilization in neonatal care.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Variability in clinical presentation and complications associated with ELBW infants.
  • Need for detailed maternal history and delivery complications documentation.
  • Potential for multiple co-morbidities requiring additional coding.
  • Variations in care protocols across different healthcare settings.

Audit Risk Factors

  • Inadequate documentation of birth weight and gestational age.
  • Failure to capture associated complications or co-morbidities.
  • Misclassification of birth weight categories.
  • Lack of clarity in maternal health conditions impacting the newborn.

Specialty Focus

Medical Specialties

Neonatology

Documentation Requirements

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

Common Clinical Scenarios

Management of ELBW infants in the NICU, including respiratory support and feeding challenges.

Billing Considerations

Close monitoring of growth parameters and developmental milestones is crucial for accurate coding and care planning.

Pediatrics

Documentation Requirements

Comprehensive follow-up documentation on growth, development, and any ongoing health issues related to prematurity.

Common Clinical Scenarios

Pediatric assessments of ELBW infants transitioning from NICU to outpatient care.

Billing Considerations

Consideration of long-term outcomes and potential developmental delays in coding and care planning.

Coding Guidelines

Inclusion Criteria

Use P07.03 When
  • Follow the official ICD
  • CM guidelines for coding perinatal conditions, ensuring accurate documentation of birth weight, gestational age, and any associated maternal factors or delivery complications

Exclusion Criteria

Do NOT use P07.03 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 initial assessment of an ELBW infant in the NICU.

Documentation Requirements

Document birth weight, gestational age, and any immediate complications.

Specialty Considerations

Neonatologists should ensure comprehensive documentation of care provided.

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 ELBW, which aids in better tracking of outcomes and resource utilization in neonatal care.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of perinatal conditions, including ELBW, which aids in better tracking of outcomes and resource utilization in neonatal care.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of perinatal conditions, including ELBW, which aids in better tracking of outcomes and resource utilization in neonatal care.

Resources

Clinical References

  • •
    American Academy of Pediatrics - Neonatal Coding Guidelines

Coding & Billing References

  • •
    American Academy of Pediatrics - Neonatal Coding Guidelines

Frequently Asked Questions

What are the key factors to consider when coding for an ELBW infant?

Key factors include accurate documentation of birth weight, gestational age, maternal health conditions, and any complications that arise during delivery or postnatal care.