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ICD-10 Guide
ICD-10 CodesP13.3

P13.3

Billable

Birth injury to other long bones

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

Code Description

ICD-10 P13.3 is a billable code used to indicate a diagnosis of birth injury to other long bones.

Key Diagnostic Point:

Birth injury to other long bones refers to fractures or injuries sustained by a newborn during the process of delivery. These injuries can occur due to various factors, including the use of forceps, prolonged labor, or excessive traction during delivery. The long bones affected may include the femur, tibia, fibula, and humerus, among others. Such injuries can lead to complications such as pain, limited mobility, and the need for further medical intervention. Clinical assessment often involves physical examination and imaging studies to confirm the diagnosis and determine the extent of the injury. Management may include immobilization, pain management, and physical therapy to promote healing and restore function. Accurate coding is essential for proper documentation and reimbursement, as well as for tracking outcomes in neonatal care.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in documentation of birth injuries
  • Differentiation between types of fractures and their causes
  • Need for precise clinical details to support coding
  • Potential for multiple injuries complicating coding

Audit Risk Factors

  • Inadequate documentation of the mechanism of injury
  • Failure to specify the exact location of the fracture
  • Misclassification of the type of fracture
  • Inconsistent coding practices among providers

Specialty Focus

Medical Specialties

Neonatology

Documentation Requirements

Detailed notes on the delivery process, including any interventions used, and specific observations of the newborn's physical condition.

Common Clinical Scenarios

Fractures resulting from assisted deliveries, such as vacuum extraction or forceps use, and injuries from prolonged labor.

Billing Considerations

Neonatologists must ensure that all relevant clinical findings are documented to support the diagnosis and coding.

Pediatrics

Documentation Requirements

Comprehensive records of the child's growth and development post-injury, including any rehabilitation efforts.

Common Clinical Scenarios

Follow-up visits for infants with birth injuries, assessing recovery and any ongoing issues related to mobility.

Billing Considerations

Pediatricians should be aware of the long-term implications of birth injuries on development and document accordingly.

Coding Guidelines

Inclusion Criteria

Use P13.3 When
  • According to ICD
  • 10 coding guidelines, accurate documentation of the birth injury's nature, location, and cause is essential
  • Coders should ensure that the injury is clearly linked to the delivery process and that all relevant clinical details are included in the medical record

Exclusion Criteria

Do NOT use P13.3 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 when a newborn with a birth injury requires initial evaluation and management in the hospital.

Documentation Requirements

Documentation must include the assessment of the birth injury and any interventions performed.

Specialty Considerations

Neonatologists should ensure that all findings related to the injury are clearly documented.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of birth injuries, including P13.3, which enhances the ability to track and analyze outcomes related to neonatal care. This specificity aids in research and quality improvement initiatives.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of birth injuries, including P13.3, which enhances the ability to track and analyze outcomes related to neonatal care. This specificity aids in research and quality improvement initiatives.

Reimbursement & Billing Impact

reimbursement.

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 are the common causes of birth injuries to long bones?

Common causes include the use of forceps or vacuum extraction during delivery, prolonged labor, and excessive traction applied during the delivery process. Understanding these factors is crucial for accurate coding and management.