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v1.0.0
ICD-10 Guide
ICD-10 CodesP23.1

P23.1

Billable

Congenital pneumonia due to Chlamydia

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

Code Description

ICD-10 P23.1 is a billable code used to indicate a diagnosis of congenital pneumonia due to chlamydia.

Key Diagnostic Point:

Congenital pneumonia due to Chlamydia is a serious neonatal condition characterized by inflammation of the lungs in newborns caused by the Chlamydia trachomatis bacterium. This infection can occur when the mother is infected during pregnancy, particularly during the perinatal period. The pneumonia typically manifests within the first few days of life, presenting with symptoms such as respiratory distress, tachypnea, and hypoxia. Diagnosis is often confirmed through clinical evaluation and laboratory tests, including cultures or PCR testing for Chlamydia. The condition can lead to significant morbidity if not promptly recognized and treated, necessitating immediate medical intervention. Treatment usually involves the administration of appropriate antibiotics, and supportive care may be required in a neonatal intensive care unit (NICU) setting. Understanding the pathophysiology of this condition is crucial for effective management and coding, as it directly impacts the newborn's respiratory function and overall health.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between congenital pneumonia and other neonatal respiratory infections.
  • Need for accurate maternal history to establish the source of infection.
  • Variability in clinical presentation among affected newborns.
  • Potential for co-infections with other pathogens.

Audit Risk Factors

  • Inadequate documentation of maternal infection status.
  • Failure to specify the causative organism.
  • Misclassification of pneumonia type.
  • Lack of supporting clinical evidence for diagnosis.

Specialty Focus

Medical Specialties

Neonatology

Documentation Requirements

Detailed clinical notes on respiratory assessment, treatment protocols, and maternal history.

Common Clinical Scenarios

Newborns presenting with respiratory distress in the NICU, requiring immediate intervention.

Billing Considerations

Close monitoring for complications such as bronchopulmonary dysplasia or long-term respiratory issues.

Pediatrics

Documentation Requirements

Comprehensive records of follow-up visits, including respiratory assessments and developmental milestones.

Common Clinical Scenarios

Pediatric evaluations of infants with a history of congenital pneumonia, focusing on growth and respiratory function.

Billing Considerations

Awareness of potential long-term effects of early respiratory infections on pediatric health.

Coding Guidelines

Inclusion Criteria

Use P23.1 When
  • According to ICD
  • 10 coding guidelines, accurate coding for congenital pneumonia due to Chlamydia requires documentation of the causative organism and clinical symptoms
  • Coders must ensure that the diagnosis is supported by clinical findings and laboratory results, and that it is clearly linked to the maternal infection

Exclusion Criteria

Do NOT use P23.1 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 congenital pneumonia is admitted for evaluation.

Documentation Requirements

Document the newborn's clinical status, including respiratory assessment and treatment plan.

Specialty Considerations

Neonatologists should ensure thorough documentation of the newborn's respiratory condition and response to treatment.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of congenital pneumonia, enabling better tracking of conditions like P23.1. This specificity aids in research, treatment protocols, and reimbursement processes, enhancing overall neonatal care.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of congenital pneumonia, enabling better tracking of conditions like P23.1. This specificity aids in research, treatment protocols, and reimbursement processes, enhancing overall neonatal care.

Reimbursement & Billing Impact

reimbursement processes, enhancing overall neonatal care.

Resources

Clinical References

  • •
    CDC Guidelines on Chlamydia in Pregnancy

Coding & Billing References

  • •
    CDC Guidelines on Chlamydia in Pregnancy

Frequently Asked Questions

What are the common symptoms of congenital pneumonia due to Chlamydia?

Common symptoms include respiratory distress, tachypnea, and hypoxia, often presenting within the first few days of life. Early recognition and treatment are crucial for positive outcomes.