Z38 used with 3 year old patient

sgaletka

New
Messages
3
Best answers
0
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,
Sarah
 

mitchellde

True Blue
Messages
13,537
Location
Columbia, MO
Best answers
2
A child has been in acute care inpatient since birth for three years? At some point was the child's status converted to long term care? With long term stays , they are often billed as 30 day intervals. In which case use the z38 only for the first 30 day, after that the condition that necessitates continued inpatient care.
 

sgaletka

New
Messages
3
Best answers
0
Follow up to mitchellde response

Hello -

Thanks for the response. I have some follow up questions.

The patient is still in acute care and has never left acute care. They transferred from delivery to NICU then to PICU. That is why we are questioning whether the use of the Z38 is correct as a primary DX.

I am also looking at the definition of primary DX below. Can someone clarify what it means that the primary dx is the one used "after study"? Does this mean a P or Q code would be the more appropriate primary DX?

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.""


Thanks
Sarah
 

CodingKing

True Blue
Messages
3,955
Best answers
1
No, I would not include Z38 after the first interim claim. All subsequent claims should be coded as the reason the patient is still in the hospital.
 
Top