Scenarios Illustrate How to Use New ICD-10-CM Codes

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The new International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) codes take effect on Oct.1. It is important to use all new codes on and after that date.

Payer systems will be updated. To avoid denials, ensure your systems are updated and that you are using the current ICD-10-CM manual.

Following are scenarios where new ICD-10-CM codes will be reported.

Serenity Bay Chronicles

Fetal inflammatory response syndrome

An infant is born via cesarean section at 32 weeks, 3 days post-conceptual age two weeks after premature rupture of membranes. The infant exhibits signs and symptoms of sepsis, including hypotension and acute kidney injury, but blood, spinal fluid and urine cultures are negative. Laboratory investigation reveals increased concentration of IL-6 and TNF-alpha. Histopathology of the placenta revealed funisitis and signs of placental inflammation.

ICD-10-CM codes reported:

Z38.01 Single liveborn infant, delivered by cesarean

P07.35 Preterm newborn, gestational age 32 completed weeks

P02.70 Newborn affected by fetal inflammatory response syndrome

Newborn with hypokalemia

An infant born vaginally at 24 post-conceptual weeks has severe evolving chronic lung disease, respiratory failure and hypercarbia. Routine serum electrolytes are sodium 135 mEq/L, potassium 2.8 mEq/L, chloride 98 mEq/L and bicarbonate 30 mEq/L. The infant is treated with potassium chloride supplementation, with gradual resolution of hypokalemia.

ICD-10-CM codes reported:

Z38.00 Single liveborn infant, delivered vaginally

P07.23 Extreme immaturity of newborn, gestational age 24 completed weeks

P27.9 Unspecified chronic respiratory disease originating in the perinatal period

P28.5 Respiratory failure of newborn

P74.32 Hypokalemia of newborn

P84 Other problems with newborn (hypercarbia)

Newborn with hyperkalemia

A full-term infant suffers severe perinatal asphyxia. Urine output is 0.2 mL/kg/hour, and creatinine on day 3 has risen to 2.5 mg/dL. Serum electrolytes reveal an elevated serum potassium of 7.3 mEq/L, and the baby requires treatment.

ICD-10-CM codes reported:

Z38.00 Single liveborn infant, delivered vaginally

P74.32 Hyperkalemia of newborn

P84 Other problems with newborn (perinatal asphyxia)

Baby with exposure to opiates

A full-term infant is born to a mother who had been taking prescribed oxycodone for severe back pain for two months prior to the birth. Initially, the infant is well but begins to exhibit jitteriness, irritability and poor feeding. Finnegan scoring is begun with scores in the 10-12 range. The infant responds well to oral morphine therapy, with eventual weaning from morphine at 2 weeks of life.

ICD-10-CM codes reported:

Z38.00 Single liveborn infant, delivered vaginally

P04.14 Newborn affected by maternal use of opiates

Angelman syndrome

A 3-year-old patient transfers to your practice. The mom presents with extensive records. At the appointment, the physician addresses the patient’s condition, earlier identified as Angelman syndrome, and provides new referrals for specialists.

ICD-10-CM code reported:

Q93.51 Angelman syndrome

Duchenne muscular dystrophy

A 4-year-old patient with Duchenne muscular dystrophy presents to the office for follow-up. The mom wants to discuss recent treatment options and the possibility of the child entering school soon.

ICD-10-CM code reported:

G71.01 Duchenne or Becker muscular dystrophy

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