ICD-10 Coding for Hyperbilirubinemia(P59.9, P58.0)
Complete ICD-10-CM coding and documentation guide for Hyperbilirubinemia. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Hyperbilirubinemia
P55-P59Primary Range
Neonatal jaundice and other perinatal conditions
This range includes codes for various types of neonatal jaundice, including unspecified and specific causes.
Disorders of bilirubin metabolism
This range covers metabolic disorders affecting bilirubin levels, such as Gilbert's syndrome.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| P59.9 | Unspecified neonatal jaundice | Use when the cause of neonatal jaundice is not specified in the documentation. |
|
| P58.0 | Neonatal jaundice due to hemolytic disease | Use when jaundice is caused by hemolytic disease, confirmed by lab tests. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for neonatal jaundice
Essential facts and insights about Hyperbilirubinemia
Primary ICD-10-CM Codes for hyperbilirubinemia
Decision Criteria
documentation Criteria
- Jaundice without a specified cause
Applicable To
- Neonatal jaundice of unknown origin
Excludes
- Jaundice due to other specified causes
Clinical Validation Requirements
- Gestational age documentation
- Absence of specific cause documentation
Code-Specific Risks
- Assuming unspecified jaundice without proper documentation
Coding Notes
- Ensure documentation specifies if jaundice is due to prematurity or other causes.
P58.0 - Neonatal jaundice due to hemolytic disease
Use when jaundice is caused by hemolytic disease, confirmed by lab tests.
Applicable To
- Jaundice due to isoimmunization
Excludes
- Jaundice due to other causes
Clinical Validation Requirements
- Positive Coombs test
- Blood type incompatibility
Coding Notes
Ensure documentation includes lab results confirming hemolytic disease.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Hyperbilirubinemia to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code P59.9.
Impact
Clinical: Inadequate treatment planning., Regulatory: Non-compliance with documentation standards., Financial: Potential claim denials.
Mitigation Strategy
Always document TSB levels, Use standardized templates
Impact
Reimbursement: Incorrect coding can lead to denied claims., Compliance: Non-compliance with ICD-10 guidelines., Data Quality: Inaccurate clinical data reporting.
Mitigation Strategy
Use P59.9 or other specific neonatal jaundice codes.
Impact
Failure to document TSB levels and risk factors.
Mitigation Strategy
Use comprehensive templates and checklists.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Hyperbilirubinemia, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Hyperbilirubinemia
Use these documentation templates to ensure complete and accurate documentation for Hyperbilirubinemia. These templates include all required elements for proper coding and billing.
Neonatal jaundice assessment
Specialty: PediatricsRequired Elements
- Gestational age
- TSB levels
- Risk factors
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
Need help with ICD-10 coding for Hyperbilirubinemia? Ask your questions below.