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ICD-10 Guide
ICD-10 CodesP07.18

P07.18

Billable

Other low birth weight newborn, 2000-2499 grams

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

Code Description

ICD-10 P07.18 is a billable code used to indicate a diagnosis of other low birth weight newborn, 2000-2499 grams.

Key Diagnostic Point:

P07.18 is used to classify newborns who weigh between 2000 and 2499 grams at birth, which is considered low birth weight. This condition can arise from various maternal factors such as preeclampsia, gestational diabetes, or inadequate prenatal care, as well as complications during delivery like preterm labor or placental insufficiency. Newborns in this weight category are at increased risk for several health issues, including respiratory distress syndrome, feeding difficulties, and infections. Proper management in a neonatal intensive care unit (NICU) is often required to monitor and address these potential complications. The coding of this condition necessitates a thorough understanding of the underlying maternal and delivery-related factors contributing to low birth weight, as well as the clinical implications for the newborn's health and development.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in maternal health conditions affecting birth weight
  • Need for detailed 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 history
  • Failure to capture delivery complications
  • Misclassification of birth weight categories
  • Inconsistent coding of associated conditions

Specialty Focus

Medical Specialties

Neonatology

Documentation Requirements

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

Common Clinical Scenarios

Newborns requiring NICU admission for monitoring due to low birth weight and associated risks.

Billing Considerations

Ensure accurate coding of any additional diagnoses or complications that may arise during the newborn's hospital stay.

Pediatrics

Documentation Requirements

Comprehensive follow-up notes on growth and development milestones post-discharge.

Common Clinical Scenarios

Pediatric visits for growth monitoring and management of complications stemming from low birth weight.

Billing Considerations

Consider the long-term implications of low birth weight on pediatric health and development.

Coding Guidelines

Inclusion Criteria

Use P07.18 When
  • Follow the official ICD
  • CM guidelines for coding perinatal conditions, ensuring accurate documentation of birth weight, gestational age, and any maternal factors or delivery complications

Exclusion Criteria

Do NOT use P07.18 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

99460CPT Code

Initial hospital care for newborns

Clinical Scenario

Used for the initial assessment of a low birth weight newborn in the NICU.

Documentation Requirements

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

Specialty Considerations

Neonatologists should ensure comprehensive documentation of the newborn's condition.

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, enhancing the ability to capture the nuances of neonatal care and improving data accuracy for research and quality improvement initiatives.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of low birth weight conditions, enhancing the ability to capture the nuances of neonatal care and improving data accuracy for research and quality improvement initiatives.

Reimbursement & Billing Impact

reimbursement and quality reporting.

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 P07.18?

Factors include maternal health conditions such as hypertension, diabetes, inadequate prenatal care, and complications during delivery like preterm labor or placental insufficiency.