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ICD-10 Guide
ICD-10 CodesP09.3

P09.3

Billable

Abnormal findings on neonatal screening for congenital hematologic disorders

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

Code Description

ICD-10 P09.3 is a billable code used to indicate a diagnosis of abnormal findings on neonatal screening for congenital hematologic disorders.

Key Diagnostic Point:

P09.3 refers to abnormal findings identified during neonatal screening for congenital hematologic disorders, which include conditions such as sickle cell disease, thalassemia, and other inherited blood disorders. These screenings are critical as they help in the early identification of potentially life-threatening conditions that can affect a newborn's health. The screening typically occurs within the first few days of life and involves blood tests that analyze the newborn's hemoglobin and other hematologic parameters. Maternal factors, such as a family history of hematologic disorders, maternal diabetes, or infections during pregnancy, can influence the likelihood of these conditions. Delivery complications, including asphyxia or trauma, may also impact the newborn's hematologic status. Early detection through screening allows for timely interventions, which can significantly improve outcomes for affected infants. It is essential for healthcare providers to document the findings accurately and to follow up with appropriate care plans based on the screening results.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of congenital hematologic disorders requiring specific documentation.
  • Need for accurate interpretation of screening results.
  • Potential for overlapping symptoms with other conditions.
  • Variability in state-specific screening protocols.

Audit Risk Factors

  • Inadequate documentation of maternal health history.
  • Failure to report follow-up care for abnormal findings.
  • Misinterpretation of screening results leading to incorrect coding.
  • Lack of clarity in the newborn's clinical status post-screening.

Specialty Focus

Medical Specialties

Neonatology

Documentation Requirements

Detailed records of screening results, follow-up tests, and treatment plans.

Common Clinical Scenarios

Newborns with abnormal hemoglobin levels requiring NICU admission for further evaluation.

Billing Considerations

Consideration of maternal factors such as genetic history and prenatal care.

Pediatrics

Documentation Requirements

Comprehensive pediatric assessments including family history and developmental milestones.

Common Clinical Scenarios

Pediatric follow-up for infants diagnosed with congenital hematologic disorders.

Billing Considerations

Monitoring growth and development in infants with identified hematologic issues.

Coding Guidelines

Inclusion Criteria

Use P09.3 When
  • According to the official ICD
  • 10 coding guidelines, accurate coding for P09
  • 3 requires documentation of the specific hematologic disorder identified, the results of the screening tests, and any follow
  • up care provided
  • Coders should ensure that all relevant maternal factors are documented to support the diagnosis

Exclusion Criteria

Do NOT use P09.3 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

85025CPT Code

Complete blood count (CBC) with differential

Clinical Scenario

Used to evaluate hematologic status in newborns with abnormal screening results.

Documentation Requirements

Document the indication for the CBC and any abnormal findings.

Specialty Considerations

Neonatologists should ensure that results are interpreted in the context of the newborn's clinical picture.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of congenital hematologic disorders, improving the ability to track and manage these conditions in newborns. The granularity of ICD-10 codes facilitates better data collection and analysis for public health initiatives.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of congenital hematologic disorders, improving the ability to track and manage these conditions in newborns. The granularity of ICD-10 codes facilitates better data collection and analysis for public health initiatives.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of congenital hematologic disorders, improving the ability to track and manage these conditions in newborns. The granularity of ICD-10 codes facilitates better data collection and analysis for public health initiatives.

Resources

Clinical References

  • •
    CDC Guidelines for Newborn Screening

Coding & Billing References

  • •
    CDC Guidelines for Newborn Screening

Frequently Asked Questions

What are the common congenital hematologic disorders screened in newborns?

Common congenital hematologic disorders include sickle cell disease, thalassemia, and hereditary spherocytosis. Newborn screening programs vary by state but typically include tests for these conditions to ensure early diagnosis and management.