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ICD-10 Guide
ICD-10 CodesP83.3

P83.3

Billable

Other and unspecified edema specific to newborn

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

Code Description

ICD-10 P83.3 is a billable code used to indicate a diagnosis of other and unspecified edema specific to newborn.

Key Diagnostic Point:

P83.3 refers to other and unspecified edema in newborns, which can manifest in various forms, including sclerema neonatorum. Sclerema neonatorum is a rare but serious condition characterized by hardening of the skin due to subcutaneous fat necrosis, typically occurring in premature infants or those with low birth weight. The condition is often associated with underlying metabolic disturbances or hypothermia. Clinically, it presents as a firm, waxy, and sometimes shiny appearance of the skin, primarily affecting the extremities and buttocks. The pathophysiology involves ischemia and necrosis of the subcutaneous fat, leading to edema and skin changes. Management focuses on maintaining normothermia, supportive care, and addressing any underlying conditions. Accurate coding of P83.3 is crucial for proper reimbursement and tracking of neonatal conditions, as it encompasses a range of edema presentations that may require different clinical approaches.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation of edema types
  • Need for differentiation from other skin conditions
  • Potential overlap with other ICD codes
  • Documentation requirements for underlying causes

Audit Risk Factors

  • Inadequate documentation of clinical findings
  • Misclassification of edema types
  • Failure to document underlying conditions
  • Inconsistent coding practices across providers

Specialty Focus

Medical Specialties

Neonatology

Documentation Requirements

Detailed clinical notes on the infant's condition, including gestational age, weight, and any associated symptoms.

Common Clinical Scenarios

Sclerema neonatorum in a premature infant, generalized edema in a newborn with congenital heart disease.

Billing Considerations

Consideration of the infant's overall clinical picture and potential comorbidities is essential for accurate coding.

Pediatrics

Documentation Requirements

Comprehensive history and physical examination notes, including family history and any relevant prenatal factors.

Common Clinical Scenarios

Follow-up visits for infants with a history of edema, management of underlying conditions contributing to edema.

Billing Considerations

Pediatricians should be aware of the long-term implications of neonatal edema and its potential impact on growth and development.

Coding Guidelines

Inclusion Criteria

Use P83.3 When
  • According to ICD
  • 10 coding guidelines, P83
  • 3 should be used when the specific cause of edema is not documented or when it encompasses multiple types of edema that do not fit into more specific categories

Exclusion Criteria

Do NOT use P83.3 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

99291CPT Code

Critical care, evaluation and management of the critically ill infant

Clinical Scenario

Used when managing a newborn with severe edema requiring intensive monitoring.

Documentation Requirements

Detailed notes on the infant's clinical status, interventions, and response to treatment.

Specialty Considerations

Neonatologists should ensure accurate documentation of the critical care provided.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of neonatal conditions, including edema. P83.3 provides a broader category for edema that may not have a clearly defined cause, improving the granularity of data collection and reimbursement processes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of neonatal conditions, including edema. P83.3 provides a broader category for edema that may not have a clearly defined cause, improving the granularity of data collection and reimbursement processes.

Reimbursement & Billing Impact

reimbursement processes.

Resources

Clinical References

  • •
    American Academy of Pediatrics - Neonatal Coding Guidelines

Coding & Billing References

  • •
    American Academy of Pediatrics - Neonatal Coding Guidelines

Frequently Asked Questions

What are the common causes of edema in newborns?

Common causes of edema in newborns include congenital heart disease, metabolic disorders, and sclerema neonatorum. Accurate diagnosis and documentation are essential for appropriate coding.