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ICD-10 Guide
ICD-10 CodesP07.10

P07.10

Billable

Other low birth weight newborn, unspecified weight

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

Code Description

ICD-10 P07.10 is a billable code used to indicate a diagnosis of other low birth weight newborn, unspecified weight.

Key Diagnostic Point:

P07.10 is used to classify newborns who are born with low birth weight but do not fit into the specific weight categories defined by other codes. Low birth weight is defined as a birth weight of less than 2500 grams (5 pounds, 8 ounces). This condition can arise from various maternal factors such as inadequate prenatal care, maternal smoking, substance abuse, infections, or chronic health conditions like hypertension or diabetes. Delivery complications, including preterm labor, placental abruption, or intrauterine growth restriction (IUGR), can also contribute to low birth weight. Newborns classified under this code may require specialized care in a Neonatal Intensive Care Unit (NICU) due to their increased risk for complications such as respiratory distress syndrome, feeding difficulties, and infections. Accurate coding is essential for appropriate management and resource allocation in neonatal care.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in maternal health conditions affecting birth weight
  • Need for precise documentation of delivery complications
  • Differentiation from other low birth weight categories
  • Potential for co-morbid conditions requiring additional coding

Audit Risk Factors

  • Inadequate documentation of maternal health factors
  • Failure to specify delivery complications
  • Misclassification of birth weight categories
  • Inconsistent coding practices among providers

Specialty Focus

Medical Specialties

Neonatology

Documentation Requirements

Detailed records of birth weight, gestational age, and any complications during delivery or maternal health issues.

Common Clinical Scenarios

Newborns admitted to the NICU for respiratory support or feeding difficulties due to low birth weight.

Billing Considerations

Ensure accurate tracking of growth and development milestones in follow-up visits.

Pediatrics

Documentation Requirements

Comprehensive history of prenatal care, maternal health, and any postnatal complications.

Common Clinical Scenarios

Pediatric follow-ups for low birth weight infants to monitor growth and developmental progress.

Billing Considerations

Consider the long-term implications of low birth weight on health outcomes.

Coding Guidelines

Inclusion Criteria

Use P07.10 When
  • Follow the official ICD
  • CM guidelines for coding low birth weight, ensuring that all relevant maternal and delivery factors are documented
  • Use additional codes to capture any associated conditions

Exclusion Criteria

Do NOT use P07.10 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 a low birth weight newborn in the NICU.

Documentation Requirements

Document the infant's weight, gestational age, and any complications.

Specialty Considerations

Neonatologists should ensure comprehensive assessments are documented.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of low birth weight conditions, improving the ability to track and manage these cases effectively.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of low birth weight conditions, improving the ability to track and manage these cases effectively.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of low birth weight conditions, improving the ability to track and manage these cases effectively.

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 factors contribute to a newborn being classified under P07.10?

Factors include maternal health issues such as diabetes, hypertension, smoking, and delivery complications like preterm labor or IUGR. Accurate documentation of these factors is crucial for proper coding.