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ICD-10 Guide
ICD-10 CodesP61.8

P61.8

Billable

Other specified perinatal hematological disorders

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

Code Description

ICD-10 P61.8 is a billable code used to indicate a diagnosis of other specified perinatal hematological disorders.

Key Diagnostic Point:

Perinatal hematological disorders encompass a range of conditions affecting the blood and its components in newborns. The code P61.8 specifically refers to other specified perinatal hematological disorders that do not fall under more common categories such as anemia or thrombocytopenia. Conditions like thrombocytopenia, characterized by low platelet counts, can lead to increased bleeding risks in neonates, necessitating careful monitoring and management. Polycythemia, on the other hand, involves an elevated red blood cell mass, which can result in hyperviscosity and complications such as jaundice and respiratory distress. These disorders may arise from various etiologies, including maternal conditions, genetic factors, or complications during delivery. Accurate diagnosis and coding are crucial for appropriate management and follow-up care, as these hematological issues can significantly impact a newborn's health outcomes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of underlying causes leading to hematological disorders
  • Need for precise laboratory results to confirm diagnosis
  • Differentiation between similar conditions (e.g., thrombocytopenia vs. polycythemia)
  • Potential for co-morbid conditions that complicate coding

Audit Risk Factors

  • Inadequate documentation of laboratory results
  • Failure to specify the type of hematological disorder
  • Misclassification of conditions due to overlapping symptoms
  • Lack of clarity in the clinical rationale for diagnosis

Specialty Focus

Medical Specialties

Neonatology

Documentation Requirements

Detailed lab results, clinical assessments, and treatment plans must be documented to support the diagnosis of hematological disorders.

Common Clinical Scenarios

Neonates presenting with unexplained bruising, prolonged bleeding after procedures, or signs of respiratory distress due to polycythemia.

Billing Considerations

Neonatologists must ensure that all relevant clinical data is captured to justify the use of P61.8, especially in cases with multiple hematological issues.

Pediatrics

Documentation Requirements

Pediatricians should document any ongoing management of hematological disorders, including follow-up lab tests and treatment responses.

Common Clinical Scenarios

Pediatric patients with a history of perinatal hematological disorders requiring long-term monitoring or intervention.

Billing Considerations

Consideration of developmental impacts and potential long-term outcomes related to perinatal hematological conditions.

Coding Guidelines

Inclusion Criteria

Use P61.8 When
  • Coders should adhere to the official ICD
  • CM guidelines, ensuring that all documentation supports the diagnosis
  • Specific criteria for perinatal conditions must be met, including gestational age and clinical findings

Exclusion Criteria

Do NOT use P61.8 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

36415CPT Code

Collection of venous blood by venipuncture

Clinical Scenario

Used for obtaining blood samples for hematological testing in neonates.

Documentation Requirements

Document the reason for blood draw and any relevant clinical findings.

Specialty Considerations

Neonatologists should ensure that blood draws are performed with appropriate techniques to minimize trauma.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of perinatal hematological disorders, improving the accuracy of diagnoses and facilitating better tracking of patient outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of perinatal hematological disorders, improving the accuracy of diagnoses and facilitating better tracking of patient outcomes.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of perinatal hematological disorders, improving the accuracy of diagnoses and facilitating better tracking of patient outcomes.

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 perinatal hematological disorders?

Common causes include maternal health issues such as gestational diabetes, infections, and genetic factors. Conditions like thrombocytopenia and polycythemia can arise from these maternal conditions or complications during delivery.