Z38 being used for 3 year old patient


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Hello -

The ICD 10 coding guidelines for chapter 16 states "Z38 is assigned only once, to a newborn at the time of birth. If a newborn is transferred to another institution, a code from category Z38 should not be used at the receiving hospital."

If the newborn was never discharged from the hospital, and is now 3 years old, is it appropriate to still use the Z38 as the primary diagnosis? Another thought is that the code is only appropriate for ages 0-28 days.

In section 2 of selection of principle DX it states the following:
"The circumstances of the inpatient admission always govern the selection of the principle diagnosis. The principal diagnosis is defined in the Uniform Hospital Discharge Data Set (UHDDS) as "that condition established after study to be chiefly responsible for occasioning the admission of the patient to the hospital for care.""

Does this mean that a "P" or "Q" diagnosis code would be used as a possible dx in this case as it would be the "...condition established after study to be chiefly responsible" or because the patient was never discharged initially from the birth, or is the Z38 still appropriate for a patient who has been in the hospital since birth to age 3?

I appreciate any responses received.

Thank you,