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v1.0.0
ICD-10 Guide
ICD-10 CodesP22.9

P22.9

Billable

Respiratory distress of newborn, unspecified

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

Code Description

ICD-10 P22.9 is a billable code used to indicate a diagnosis of respiratory distress of newborn, unspecified.

Key Diagnostic Point:

Respiratory distress in newborns is a clinical condition characterized by difficulty in breathing that can arise from various underlying causes. This condition is particularly common in preterm infants due to immature lung development, leading to conditions such as hyaline membrane disease (HMD), also known as neonatal respiratory distress syndrome (NRDS). HMD is primarily caused by a deficiency of surfactant, a substance that reduces surface tension in the alveoli, preventing their collapse. Another common cause of respiratory distress in newborns is transient tachypnea of the newborn (TTN), which is often seen in infants born via cesarean delivery without preceding labor. TTN is characterized by rapid breathing due to fluid retention in the lungs. The clinical presentation of respiratory distress may include grunting, nasal flaring, retractions, and cyanosis. Accurate diagnosis and management are critical, as respiratory distress can lead to significant morbidity if not addressed promptly. Treatment may involve supplemental oxygen, continuous positive airway pressure (CPAP), or mechanical ventilation, depending on the severity of the condition. Understanding the nuances of respiratory distress is essential for effective neonatal care and coding.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of underlying causes for respiratory distress
  • Differentiation between HMD and TTN
  • Variability in clinical presentation
  • Need for precise documentation of clinical findings

Audit Risk Factors

  • Inadequate documentation of clinical findings
  • Misclassification of respiratory distress types
  • Failure to document treatment interventions
  • Inconsistent use of terminology in medical records

Specialty Focus

Medical Specialties

Neonatology

Documentation Requirements

Detailed documentation of respiratory assessment, including vital signs, oxygen saturation levels, and interventions.

Common Clinical Scenarios

Infants presenting with respiratory distress in the NICU, requiring CPAP or mechanical ventilation.

Billing Considerations

Coders should ensure that all relevant clinical findings are documented to support the diagnosis of respiratory distress.

Pediatrics

Documentation Requirements

Documentation of respiratory history, physical examination findings, and treatment plans.

Common Clinical Scenarios

Pediatric follow-up visits for newborns with a history of respiratory distress.

Billing Considerations

Consideration of developmental milestones and ongoing respiratory assessments in pediatric care.

Coding Guidelines

Inclusion Criteria

Use P22.9 When
  • Coders should refer to the official ICD
  • CM coding guidelines for perinatal conditions, ensuring that all documentation supports the diagnosis and that any additional codes for associated conditions are included

Exclusion Criteria

Do NOT use P22.9 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

94640CPT Code

Continuous positive airway pressure (CPAP) therapy

Clinical Scenario

Used for infants with respiratory distress requiring respiratory support.

Documentation Requirements

Document the indication for CPAP and the infant's response to therapy.

Specialty Considerations

Neonatologists should ensure that the use of CPAP is well-documented in the context of respiratory distress.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of respiratory distress conditions, improving the accuracy of data collection and reimbursement processes. Coders must be familiar with the nuances of the new codes to ensure compliance and proper reimbursement.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of respiratory distress conditions, improving the accuracy of data collection and reimbursement processes. Coders must be familiar with the nuances of the new codes to ensure compliance and proper reimbursement.

Reimbursement & Billing Impact

reimbursement processes. Coders must be familiar with the nuances of the new codes to ensure compliance and proper 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 respiratory distress in newborns?

Common causes include hyaline membrane disease, transient tachypnea of the newborn, pneumonia, and congenital anomalies affecting the respiratory system.