We are routinely asked by neonatologists to provide a consultation for patients who are admitted in premature labor or with poor fetal growth. The diagnosis codes for prematurity or intrauterine growth retardation cannot be used because they are newborn codes and the consultation is performed prior to birth. What diagnosis codes should be used?

You are correct that you cannot report the newborn diagnosis codes. In these cases you will be reporting your services under the mother’s insurance and will report the International Classification of Diseases, Ninth Revision, Clinical Modification codes that pertain to the problem or complication. For instance, poor fetal growth would be reported with code 656.53 and threatened premature labor would be reported with codes 644.03 or 644.13, depending on the completed weeks of gestation. Be sure your medical record documentation meets the Current Procedural Terminology requirements needed to report a consultation.

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