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v1.0.0
ICD-10 Guide
ICD-10 CodesP07.30

P07.30

Billable

Preterm newborn, unspecified weeks of gestation

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

Code Description

ICD-10 P07.30 is a billable code used to indicate a diagnosis of preterm newborn, unspecified weeks of gestation.

Key Diagnostic Point:

P07.30 is used to classify newborns who are born preterm, meaning they are delivered before 37 weeks of gestation. This code is particularly relevant when the exact gestational age is not specified. Preterm birth can result from various maternal factors, including infections, chronic conditions (such as hypertension or diabetes), and complications during pregnancy (like placental abruption or previa). Newborns classified under this code may face numerous health challenges, including respiratory distress syndrome, feeding difficulties, and increased risk of infections. The management of preterm newborns often requires specialized care in a Neonatal Intensive Care Unit (NICU), where they can receive support for their immature organ systems. Understanding the implications of preterm birth is crucial for healthcare providers, as it influences the clinical approach and long-term outcomes for these vulnerable infants.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in gestational age reporting
  • Differentiation between preterm and low birth weight
  • Documentation of maternal factors affecting delivery
  • Potential for multiple co-morbidities in preterm infants

Audit Risk Factors

  • Inadequate documentation of gestational age
  • Failure to capture maternal health conditions
  • Misclassification of preterm status
  • Lack of follow-up documentation for NICU care

Specialty Focus

Medical Specialties

Neonatology

Documentation Requirements

Detailed records of gestational age, birth weight, and any complications during delivery or in the NICU.

Common Clinical Scenarios

Management of respiratory distress syndrome, feeding intolerance, and temperature regulation issues in preterm infants.

Billing Considerations

Accurate coding requires understanding of the infant's clinical status and any interventions provided.

Pediatrics

Documentation Requirements

Comprehensive history of maternal health, delivery complications, and ongoing pediatric assessments.

Common Clinical Scenarios

Follow-up care for preterm infants, including developmental assessments and management of chronic conditions.

Billing Considerations

Pediatric coders must be aware of the long-term implications of preterm birth on health outcomes.

Coding Guidelines

Inclusion Criteria

Use P07.30 When
  • Coders should refer to the official ICD
  • CM guidelines for perinatal coding, ensuring that all relevant maternal and delivery factors are documented
  • Accurate gestational age reporting is critical, and coders should be familiar with the nuances of coding preterm conditions

Exclusion Criteria

Do NOT use P07.30 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 a preterm infant in the NICU.

Documentation Requirements

Documentation must include gestational age, birth weight, and any immediate complications.

Specialty Considerations

Neonatologists must ensure comprehensive documentation to support the medical necessity of services provided.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

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

Reimbursement & Billing Impact

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

Resources

Clinical References

  • •
    American Academy of Pediatrics - Neonatal Coding Guidelines

Coding & Billing References

  • •
    American Academy of Pediatrics - Neonatal Coding Guidelines

Frequently Asked Questions

What documentation is needed to support the use of P07.30?

To support the use of P07.30, coders need clear documentation of the newborn's gestational age, any maternal health issues, and details of the delivery and immediate postnatal care. This includes any complications that may arise due to preterm birth.