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ICD-10 Guide
ICD-10 CodesP09.4

P09.4

Billable

Abnormal findings on neonatal screening for cystic fibrosis

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

Code Description

ICD-10 P09.4 is a billable code used to indicate a diagnosis of abnormal findings on neonatal screening for cystic fibrosis.

Key Diagnostic Point:

Cystic fibrosis (CF) is a genetic disorder that affects the respiratory and digestive systems, primarily due to mutations in the CFTR gene. Newborn screening for CF typically involves measuring immunoreactive trypsinogen (IRT) levels in the blood. Elevated IRT levels may indicate the presence of CF, prompting further diagnostic testing such as sweat chloride tests or genetic testing. Abnormal findings on neonatal screening for CF can lead to early intervention, which is crucial for managing the condition and improving outcomes. Early diagnosis allows for the initiation of therapies aimed at managing symptoms, preventing complications, and enhancing quality of life. It is essential for healthcare providers to document the screening results accurately, including any follow-up tests and the clinical implications of the findings. This code is particularly relevant in the context of maternal factors such as family history of CF, which may influence screening decisions and the need for genetic counseling.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in screening protocols across states and institutions
  • Need for follow-up testing and documentation of results
  • Potential for misinterpretation of screening results
  • Integration of genetic counseling and family history considerations

Audit Risk Factors

  • Inadequate documentation of screening results
  • Failure to document follow-up testing and outcomes
  • Misclassification of abnormal findings as normal
  • Lack of family history documentation

Specialty Focus

Medical Specialties

Neonatology

Documentation Requirements

Detailed records of screening results, follow-up tests, and clinical assessments.

Common Clinical Scenarios

Newborns with elevated IRT levels requiring sweat tests and genetic counseling.

Billing Considerations

Ensure accurate coding of follow-up tests and interventions based on abnormal findings.

Pediatrics

Documentation Requirements

Comprehensive documentation of family history and ongoing management plans.

Common Clinical Scenarios

Pediatric patients diagnosed with CF requiring multidisciplinary care.

Billing Considerations

Consider the long-term management implications of CF in pediatric coding.

Coding Guidelines

Inclusion Criteria

Use P09.4 When
  • Follow the official ICD
  • CM guidelines for coding perinatal conditions, ensuring accurate documentation of screening results and any subsequent diagnostic tests

Exclusion Criteria

Do NOT use P09.4 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

81220CPT Code

Cystic fibrosis mutation analysis

Clinical Scenario

Used when genetic testing is indicated following abnormal screening results.

Documentation Requirements

Document the reason for testing and results.

Specialty Considerations

Neonatologists should ensure that genetic counseling is part of the care plan.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of conditions like cystic fibrosis, improving the accuracy of data collection and reimbursement processes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like cystic fibrosis, improving the accuracy of data collection and reimbursement processes.

Reimbursement & Billing Impact

reimbursement processes.

Resources

Clinical References

  • •
    Cystic Fibrosis Foundation

Coding & Billing References

  • •
    Cystic Fibrosis Foundation

Frequently Asked Questions

What should be documented if a newborn has abnormal CF screening results?

Document the screening results, any follow-up tests performed, the outcomes of those tests, and any referrals made for genetic counseling or further management.