Wiki P00.82 vs Z20.818

[schlosser0429@yahoo.com]

I code for newborn/delivery.

Assessment & Plan
38.1 week old AGA female newborn born via vaginal delivery complicated by maternal positive GBS, adequately treated.

Plan:
See standing orders
Routine anticipatory guidance
Routine newborn care

Maternal GBS positive, adequate IAP. EOS risk screen 0.03 for well appearing infant. No cultures or antibiotics indicated. Routine vitals. Observe for 24-48 hours for signs of infection/sepsis.

Feeding:
Mother plans to breast feed exclusively. She was educated on the benefits of breastfeeding.

Hyperbilirubinemia risk: Bilitool

Dx codes billed are Z38.00 - Single liveborn infant, delivered vaginally
P00.82 - Newborn affected by (positive) maternal group b Streptococcus (GBS) colonization

My question is, if the GBS was adequately treated, can Z20.818 - Contact with and (suspected) exposure to other bacterial communicable diseases be used instead of P00.82? Or would P00.82 be used because documentation states "observe for 24-48 hours for signs of infection/sepsis"?

Any insight is greatly appreciated

 

[Cynthia Hughes]

Code P00.82 (newborn affected by maternal colonization) is reported based on the observation for the suspected condition until it is ruled out (eg, no signs or symptoms at 24 hours) and then code Z05.1 (observation and evaluation of newborn for suspected infectious condition ruled out) would be appropriate on the date that the infection is ruled out. Though the newborn's risk is low enough to not perform blood cultures or start antibiotics in the absence of symptoms, the increased observation supports code P00.82.

I hope that helps.
Cindy

 

[schlosser0429@yahoo.com]

Yes, it does help. Thank you very much for taking the time to explain