Wiki Low birth weight codes after day-of-life 28

[psallings]

I have read the guidelines that the codes in Chapter 16 can be use throughout the life of the patient if the condition is still present, but all of the codes for low birth weight also have the "N" symbol, which indicates that they should be used from age 0-28 days. Any ideas on whether or not to continue to use them?

 

[chelbi]

Good question

Notice too that the front of the ICD-10 manual has the definitions of the Age and Sex Edit Symbols under the main heading of Medicare Code Edits. I'm not saying that the only payer those are applicable to are Medicare, however, they are listed as Medicare edits specifically.

As for the N appearing next to the P codes, it is my interpretation the N refers to the age of the patient at the onset of the condition. In other words, the condition must have been present at birth (age 0). Many babies are in NICU well beyond their 28th day and the codes remain the reason of their admission to NICU and therefore remain appropriate. The documentation for a child or adult for which the P codes apply must have a direct connection provided by the physician. With the direct documented connection the supporting documents can be submitted for appeal if denied.

Thoughts?

M. Myrick, CPC, CPMA, CPC-I