Pediatric Coding Alert

Question: A first-time parent came into our office with their 3-month-old stating the infant was having trouble with feeding. What is the proper diagnosis code for this issue?

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Answer: Because the child is 3 months old and no longer considered a newborn, you’ll look to the following codes:

• R63.30 (Feeding difficulties, unspecified)
• R63.31 (Pediatric feeding disorder, acute)
• R63.32 (Pediatric feeding disorder, chronic)
• R63.39 (Other feeding difficulties).

When reporting feeding difficulties, always code to the 5th character based on the details the provider includes in their documentation.

If the patient is a newborn, which ICD-10-CM guideline Section I.C.16 defines as infants younger than 28 days, you’ll look to the P92.- (Feeding problems of newborn) code set instead.

Coding alert: ICD-10-CM has instructions for R63.31 and R63.32 to code also associated conditions such as J69.0 (Pneumonitis due to inhalation of food and vomit), R13.1- (Dysphagia), K21.- (Gastro-esophageal reflux disease), and malnutrition conditions coded to E40 (Kwashiorkor) through E46 (Unspecified protein-calorie malnutrition) when appropriate and if applicable.

Make note: You may notice F98.2 (Other feeding disorders of infancy and childhood) appear as a coding choice when you are researching this condition, but this code is only appropriate when the documentation shows that the patient is experiencing the following symptoms:

• Repeated regurgitation of food after eating
• The behavior has persisted for at least a month
• No underlying medical cause explains the symptoms (such as gastroesophageal reflux disease [GERD], pyloric stenosis, or another digestive disorder)
• The behavior is not better explained by another eating disorder or mental health condition.

Lindsey Bush, BA, MA, CPC, Production Editor, AAPC