If the physician or other qualified health care professional diagnoses “late preterm” in a neonate of 37 weeks’ gestation, do not assign codes for late preterm. Assign codes for any identified conditions, such as small for gestational age or light for dates (see category P05). Attending physicians report codes from category Z38 (live-born infants according to place of birth and type of delivery) first. Assign an International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) code in category P07 (ie, P07.37–P07.39) for a diagnosis of late preterm for neonates born at 34 0/7 through 36 6/7 weeks’ gestation.

Yes. If an issue involving noncompliance with Health Insurance Portability and Accountability Act standards for transactions, code sets, unique identifiers (employer and provider identifiers), or operating rules cannot be resolved through direct communication with a payer, you may file a complaint with the Centers for Medicare & Medicaid...

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