Perinatal Conditions

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Chapter 23

• Perinatal Conditions

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• Perinatal period beginning before birth and
  lasting through the 28th day of life
• Main term Birth
• Subterms neonatal, fetal

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Classification of Births

• V30 - V39 is principal diagnosis for any newborn
• First axis for coding-whether single or multiple
• Multiple births indicate whether mates were
  liveborn or stillborn

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• Fourth digit indicates the birth occurred in the
  hospital or immediately before admission
• 5th digit indicates whether there was a cesarean
  delivery

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• Codes only assigned to the newborns record AND
• Only to the admission in which the infant was
  born
• Do not use on transfers

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Other Diagnoses for Newborns

• Codes from V30 through V39 indicate only that a
  birth occurred
• Additional codes are assigned for clinically
  significant conditions noted on exam

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• Insignificant or transient conditions that
  resolve without treatment are not coded

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Prematurity, Low Birth Weight and Postmaturity

• Prematurity (immaturity) is classified into
  category 765
• Immaturity birth weight of less than 1000 grams
  and/or gestation of less than 28 completed weeks
• Prematurity birth weight of 1000-2499 grams
  and/or a gestation of 28-37 completed weeks

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• Fifth digits are used to indicate birth weight
• 5th digit should correspond to diagnosis
  (prematurity/immaturity)

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• Codes 764 765 not assigned on birth weight
  alone but also on physicians evaluation

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Fetal Distress and Asphyxia

• These codes are assigned to the newborns record
  only when the condition is specifically
  identified by the physician.
• Review Meconium Aspiration

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Observation and Evaluation of Newborns and Infants

• Code V29 is assigned when a healthy newborn is
  evaluated for a suspected condition that is found
  not to be present when study is complete

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• Is assigned only during perinatal period 1st 28
  days of life
• If newborn presents signs/symptoms or when a
  definite condition is identified, do not assign
  V29

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• Instead, assign codes for signs/symptoms or
  condition which was found

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• V29 Can be assigned as
• Principal diagnosis
• Secondary diagnosis

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• Principal Use V29 for a later admission when
  codes V30-V37 no longer apply

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• Secondary use V29 along with a code from
  category V30 through V39 if newborn is further
  evaluated during episode where birth occurred.

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Infections Originating During the Perinatal Period

• ELISA or Western blot tests of newborns with
  HIV-positive mothers
• Inconclusive tests results 795.71

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Maternal Conditions Affecting the Fetus or
Newborn

• 760 763
• are assigned only on the newborns record AND
• only when the maternal condition is the cause of
  morbidity or mortality in the newborn.

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Routine Vaccination of Newborns

• Newborns are vaccinated shortly after birth. New
  V codes have been developed for assignment as
  additional codes during newborns stay to
  indicate the need for the vaccination.

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Health Supervision of Infant/Child

• Category V20 is assigned for routine encounters
  of infants when no problem has been identified.