ICD-10 Coding for Neonatal Hyperbilirubinemia(P59.9, P59.0, P58.0, P59.3)
Complete ICD-10-CM coding and documentation guide for Neonatal Hyperbilirubinemia. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Neonatal Hyperbilirubinemia
P58-P59Primary Range
Neonatal jaundice due to other excessive hemolysis and other neonatal jaundice
This range includes all codes related to neonatal jaundice, including those due to hemolysis and other causes.
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 | Neonatal jaundice, unspecified | Use when the cause of jaundice is not specified or known. |
|
| P59.0 | Neonatal jaundice associated with prematurity | Use when jaundice is explicitly linked to prematurity. |
|
| P58.0 | Neonatal jaundice due to hemolytic disease | Use when jaundice is due to hemolytic disease. |
|
| P59.3 | Neonatal jaundice due to breast milk inhibitor | Use when jaundice is linked to breastfeeding. |
|
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 hyperbilirubinemia
Essential facts and insights about Neonatal Hyperbilirubinemia
Primary ICD-10-CM Codes for neonatal hyperbilirubinemia
Decision Criteria
clinical Criteria
- Jaundice with no specified cause
Applicable To
- Physiologic jaundice
- Jaundice of unknown origin
Excludes
- Jaundice due to hemolytic disease (P58.0)
Clinical Validation Requirements
- TSB levels
- Absence of hemolysis
Code-Specific Risks
- Incorrectly using for non-neonatal jaundice
Coding Notes
- Ensure documentation specifies neonatal context to avoid using R17.
P59.0 - Neonatal jaundice associated with prematurity
Use when jaundice is explicitly linked to prematurity.
Applicable To
- Jaundice due to preterm birth
Clinical Validation Requirements
- Gestational age <37 weeks
- TSB levels
Coding Notes
Ensure documentation links jaundice to prematurity.
P58.0 - Neonatal jaundice due to hemolytic disease
Use when jaundice is due to hemolytic disease.
Applicable To
- ABO/Rh incompatibility
Clinical Validation Requirements
- Positive DAT
- Evidence of hemolysis
Coding Notes
Ensure documentation includes hemolytic test results.
P59.3 - Neonatal jaundice due to breast milk inhibitor
Use when jaundice is linked to breastfeeding.
Applicable To
- Breast milk jaundice
Clinical Validation Requirements
- Jaundice persisting >1 week
- Breastfeeding history
Coding Notes
Ensure documentation specifies breastfeeding as the cause.
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 Neonatal 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 assessment of jaundice severity., Regulatory: Non-compliance with documentation standards., Financial: Potential for denied claims.
Mitigation Strategy
Standardize TSB documentation in neonatal records., Educate staff on importance of TSB levels.
Impact
Reimbursement: Incorrect DRG assignment leading to reimbursement issues., Compliance: Non-compliance with neonatal coding guidelines., Data Quality: Inaccurate data representation for neonatal conditions.
Mitigation Strategy
Always use P59.9 for neonatal jaundice.
Impact
Reimbursement: Potential for incorrect DRG assignment., Compliance: Non-compliance with coding standards., Data Quality: Misrepresentation of clinical data.
Mitigation Strategy
Ensure gestational age is documented and linked to jaundice.
Impact
Incorrect use of unspecified codes.
Mitigation Strategy
Educate coders on specific neonatal codes.
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 Neonatal Hyperbilirubinemia, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Neonatal Hyperbilirubinemia
Use these documentation templates to ensure complete and accurate documentation for Neonatal Hyperbilirubinemia. These templates include all required elements for proper coding and billing.
Neonatal jaundice in a term infant
Specialty: PediatricsRequired Elements
- TSB levels
- Feeding history
- Gestational age
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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