Much focus has been paid to the new International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) codes for suspected conditions ruled out in neonates (Z05.-). However, infants and children also present with suspected conditions, and code selection depends largely on the reason for suspicion and outcome of examination. Several of the official guidelines for ICD-10-CM apply when selecting diagnosis codes for suspected conditions.

A suspected condition may be ruled out, be confirmed, or result in an uncertain diagnosis after examination. When reporting professional services, the key to reporting correctly is to code what is known at the end of that encounter.

If a suspected condition is confirmed, the code for that condition is reported. If the diagnosis remains uncertain, the symptoms, signs, abnormal test results, or other reason for encounter should be reported. For suspected conditions that are ruled out at the time of encounter,...

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