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v1.0.0
ICD-10 Guide
ICD-10 CodesP74.422

P74.422

Billable

Hypochloremia of newborn

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

Code Description

ICD-10 P74.422 is a billable code used to indicate a diagnosis of hypochloremia of newborn.

Key Diagnostic Point:

Hypochloremia in newborns refers to a condition characterized by low levels of chloride in the blood. Chloride is an essential electrolyte that plays a critical role in maintaining acid-base balance, osmotic pressure, and proper hydration. In neonates, hypochloremia can result from various factors including inadequate intake of chloride, excessive loss through vomiting or diarrhea, or underlying metabolic disorders. It is often transient and may resolve with appropriate management. Clinicians must monitor electrolyte levels closely in newborns, especially those in the NICU or those with conditions that predispose them to electrolyte imbalances. Symptoms may include lethargy, weakness, and respiratory distress. Treatment typically involves electrolyte replacement and addressing the underlying cause. Understanding the nuances of hypochloremia is crucial for effective management and coding, as it can be associated with other electrolyte disturbances such as hyponatremia or hypokalemia, necessitating comprehensive documentation and coding.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation and underlying causes
  • Need for precise electrolyte monitoring and documentation
  • Potential association with other electrolyte imbalances
  • Differentiation from other metabolic disturbances

Audit Risk Factors

  • Inadequate documentation of electrolyte levels
  • Failure to document the clinical context or underlying conditions
  • Misclassification of electrolyte disturbances
  • Lack of follow-up documentation on treatment outcomes

Specialty Focus

Medical Specialties

Neonatology

Documentation Requirements

Detailed records of electrolyte levels, clinical symptoms, and treatment plans are essential. Documentation should include the timing of electrolyte assessments and any interventions performed.

Common Clinical Scenarios

Common scenarios include premature infants with feeding intolerance, infants with congenital anomalies affecting electrolyte absorption, and those with gastrointestinal losses.

Billing Considerations

Neonatologists must consider gestational age and weight when interpreting electrolyte levels, as normal ranges may differ significantly from older children.

Pediatrics

Documentation Requirements

Pediatric documentation should include a comprehensive history of the newborn's feeding patterns, any signs of dehydration, and family history of metabolic disorders.

Common Clinical Scenarios

Pediatricians may encounter cases of hypochloremia in infants with prolonged vomiting or diarrhea, or those with metabolic disorders.

Billing Considerations

Pediatric coders should be aware of the developmental context and potential long-term implications of electrolyte imbalances in infants.

Coding Guidelines

Inclusion Criteria

Use P74.422 When
  • Coders should adhere to official ICD
  • 10 guidelines, ensuring accurate documentation of the clinical context, laboratory results, and treatment plans
  • Specific criteria for neonatal coding must be met, including the age of the infant and the presence of any associated conditions

Exclusion Criteria

Do NOT use P74.422 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 to monitor electrolyte levels in newborns.

Documentation Requirements

Document the reason for blood draw, including clinical signs and symptoms.

Specialty Considerations

Neonatologists should ensure that blood draws are performed with minimal discomfort to the infant.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of electrolyte disturbances, including hypochloremia, enhancing the ability to track and manage these conditions in neonates.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of electrolyte disturbances, including hypochloremia, enhancing the ability to track and manage these conditions in neonates.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of electrolyte disturbances, including hypochloremia, enhancing the ability to track and manage these conditions in neonates.

Resources

Clinical References

  • •
    Neonatal Electrolyte Management Guidelines

Coding & Billing References

  • •
    Neonatal Electrolyte Management Guidelines

Frequently Asked Questions

What are the common causes of hypochloremia in newborns?

Common causes include gastrointestinal losses from vomiting or diarrhea, inadequate chloride intake, and certain metabolic disorders. It's important to assess the clinical context to determine the underlying cause.