ICD-10 Transition tips and tools

Neonatal Pneumonia Coding

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In trying to assign a code for a neonatal pneumonia, ICD-9-CM allows for specific coding of aspiration of fluids and secretions during both the birth process and postnatally. However, for aspiration of food or milk, we have always been required to report the "adult" aspiration pneumonia code of 507.0. Reporting of congenital pneumonia is reported with only one code in ICD-9-CM regardless of the type of congenital pneumonia.

So, a welcome change in ICD-10 is the expansion of codes for reporting neonatal pneumonia--aspiration and congenital. In ICD-9-CM, fetal or newborn aspiration includes aspiration of blood, clear amniotic fluid, meconium and postnatal stomach contents. In ICD-10, aspiration pneumonia in a newborn has been expanded to include the following: amniotic fluid (clear), blood, liquor (amnii), meconium, milk, mucus, food (regurgitated), specified NEC and neonatal stomach contents. These conditions will be reported with a code from the code section of P24--Neonatal Aspiration.

The table below shows the difference in code assignments.

ICD-9-CM Newborn Aspiration Codes

ICD-10-CM Newborn Aspiration Codes

770.10

Fetal and NB aspiration, unspecified

P24.9

Neonatal aspiration, unspecified

770.11

Meconium aspiration w/o respiratory symptoms

P24.00

Meconium aspiration w/o respiratory symptoms

770.12

Meconium aspiration with respiratory symptoms-includes pneumonia, pneumonitis, and meconium aspiration syndrome NEC

P24.01

Meconium aspiration with respiratory symptoms-includes pneumonia, pneumonitis, and meconium aspiration syndrome NEC

770.13

Aspiration of clear amniotic fluid w/o respiratory symptoms

P24.10

Neonatal aspiration of (clear) amniotic fluid and mucus w/o respiratory symptoms (neonatal aspiration of liquor [amnii])

770.14

Aspiration of clear amniotic fluid with respiratory symptoms-includes pneumonia and pneumonitis

P24.11

Neonatal aspiration of (clear) amniotic fluid and mucus with respiratory symptoms-includes pneumonia and pneumonitis

770.15

Aspiration of blood w/o respiratory symptoms

P24.20

Neonatal aspiration of blood w/o respiratory symptoms

770.16

Aspiration of blood with respiratory symptoms-includes pneumonia and pneumonitis

P24.11

Neonatal aspiration of blood with respiratory symptoms-includes pneumonia and pneumonitis

770.17

Other fetal and NB aspiration w/o respiratory symptoms

P24.80

Other neonatal aspiration w/o respiratory symptoms

770.18

Other fetal and NB aspiration with respiratory symptoms-includes pneumonia and pneumonitis

P24.81

Other neonatal aspiration with respiratory symptoms-includes pneumonia NOS and NEC, and pneumonitis NOS and NEC

770.85

Aspiration of postnatal stomach contents w/o respiratory symptoms

P24.30

Neonatal aspiration of milk and regurgitated food w/o respiratory symptoms (neonatal aspiration of stomach contents)

770.86

Aspiration of postnatal stomach contents with respiratory symptoms-includes pneumonia and pneumonitis

P24.31

Neonatal aspiration of milk and regurgitated food with respiratory symptoms-includes pneumonia and pneumonitis

507.0

Pneumonitis due to inhalation of food or vomitus-includes regurgitated food, gastric secretions, milk, saliva, and vomitus

 

 

Currently in ICD-9-CM, congenital pneumonia is reported with only one diagnosis code--770.0, for all types of congenital pneumonia. Thankfully, in ICD-10-CM, the code assignment for congenital pneumonia has been greatly expanded to include several types of bacteria as well as a viral origin. Congenital pneumonia covers all pneumonia's acquired prenatally or during the birth.

A comparison between the two systems is shown in the table below.

ICD-9-CM Congenital Pneumonia Codes

ICD-10-CM Congenital Pneumonia Codes

770.0

Congenital pneumonia-includes all types of infective pneumonia acquired prenatally

P23.0

Congenital pneumonia due to viral agent (excludes congenital rubella pneumonitis-P35.0)

 

 

P23.1

Congenital pneumonia due to Chlamydia

 

 

P23.2

Congenital pneumonia due to Staphylococcus

 

 

P23.3

Congenital pneumonia due to Streptococcus, group B

 

 

P23.4

Congenital pneumonia due to Escherichia coli

 

 

P23.5

Congenital pneumonia due to Pseudomonas

 

 

P23.6

Congenital pneumonia due to other bacterial agents-Hemophilus influenzae, Klebsiella pneumoniae, Mycoplasma, Streptococcus except group B

 

Add an additional code from B95-B96 to identify the organism

 

 

P23.8

Congenital pneumonia due to other organism-use additional code B97 to identify the organism

 

 

P23.9

Congenital pneumonia, unspecified

The expansion of codes in ICD-10-CM for congenital pneumonia will provide much better information for the tracking of congenital and newborn conditions, as the codes will describe neonatal conditions vs. adult conditions in a newborn.

Susan Howe is a senior health care consultant with Medical Learning Inc. (MedLearn), St. Paul, MN.

 


ICD 10 Transition tips and tools Archives
 

Will the Federal Register revise the inpatient prospective payment
Systems (IPPS) concerning the Medicare Severity DRGs (MS DRGs) to include the ICD-10-CM codes? How will the ICD-10-CM affect Present on Admission (POA)? Will these changes happen before or after the usages of the ICD-10-CM? How drastic will the Coding Clinic as we know it change with the coming of the ICD-10-CM?


Renee  McClendonAugust 11, 2009




     

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