Don't have a TCI SuperCoder account yet? Become a Member >>

Pediatric Coding Alert


Stick to 28-Day Threshold for 'Newborns' Under ICD-10

Look for feeding problem codes in the P92 range.

Although the 779.xx series may have been your best pal when coding for newborn feeding problems, that all changed when ICD-10 took effect—and you’ll have to make friends quickly with the P92 code range to ensure payment for these conditions.

Background: Feeding issues are fairly common with newborns, with conditions such as slow feeding, regurgitation, difficulty breastfeeding and other issues often being seen at pediatric practices. In most cases, these situations are fairly straightforward, but keep in mind that your coding options changed last week when ICD-10 kicked in.

Time guideline: Before you take a look at some of the new codes, keep in mind that “In ICD-10-CM, newborn remains defined as the first 28 days of life,” CMS says in its “Primer for Pediatrics Clinical Documentation Changes” in its Road to 10 reference guide.

Get A Handle on These ICD-10 Codes

Among your most common codes, you’ll replace 779.33 (Other vomiting in newborn) for a regurgitating baby with the more specific P92.1 (Regurgitation and rumination of newborn).

You’ll also find enhanced specificity for babies who feed slowly, which used to be covered with the general code 779.31 (Feeding problems in newborn), and is now more specific under P92.2 (Slow feeding of newborn).

Coder tip: If your pediatricians are accustomed to simply documenting “difficulty feeding” in the encounter notes, they’ll have to be more specific now that the codes get into greater detail. Remind the pediatricians in your practice that they should document the exact feeding problem that the baby is experiencing so you can select the most appropriate code.