EmailACS 0001 Principal diagnosis, problems with underlying conditions in the perinatal period
Publication Date: December 2011
Implementation Date: 1/07/2020
ICD 10 AM Edition: Seventh edition
Query Number: 2648
Please clarify the use of ACS 0001Principal diagnosis - Problems with underlying conditions, point two 'Coding the problem as the principal diagnosis' when applied to conditions originating in the perinatal period.
ACS 1605 Conditions originating in the perinatal period, second dot point 'Conditions originating in the perinatal period still apply for infants >28 days who are discharged and subsequently readmitted with a condition documented as originating in the perinatal period'.
With a condition such as chronic lung disease due to prematurity, from which a patient can suffer into adulthood, is it appropriate to apply 'Problems with underlying conditions' when the patient is older than 28 days?
For example, five year old patient with principal diagnosis of chronic lung disease due to prematurity (patient was born at 25 weeks gestation):
P27.1 Chronic neonatal lung disease
P07.22 Extreme immaturity, 24 or more completed weeks but less than 28 completed weeks.
Is it appropriate to use a code from P07.__ in this case?
Search Details:
ACS 0001 Principal Diagnosis
ACS 1605 Conditions originating in the perinatal period
ACS 1605 Conditions originating in the perinatal period, second dot point 'Conditions originating in the perinatal period still apply for infants >28 days who are discharged and subsequently readmitted with a condition documented as originating in the perinatal period'.
With a condition such as chronic lung disease due to prematurity, from which a patient can suffer into adulthood, is it appropriate to apply 'Problems with underlying conditions' when the patient is older than 28 days?
For example, five year old patient with principal diagnosis of chronic lung disease due to prematurity (patient was born at 25 weeks gestation):
P27.1 Chronic neonatal lung disease
P07.22 Extreme immaturity, 24 or more completed weeks but less than 28 completed weeks.
Is it appropriate to use a code from P07.__ in this case?
Search Details:
ACS 0001 Principal Diagnosis
ACS 1605 Conditions originating in the perinatal period
Response
This query was originally published in December 2011 and previously retired on 30 June 2010. It was reinstated effective 1 July 2020 following a review as the advice is considered current.
ACS 0001 Principal diagnosis applies to all patients and as such there is no age limit to the application of the Problems and underlying conditions part of standard, therefore it can be applied to a patient who is greater than 28 days. You must however have documentation of a condition clearly stated as being due to an underlying cause and the underlying cause still needs to be present.
ACS 0008 Sequelae provides guidance for coding the residual condition when the underlying cause is no longer present.
VICC does not consider the assignment of P07.22 Extreme immaturity, 24 or more completed weeks but less than 28 completed weeks is appropriate in the case cited because the prematurity is no longer present as an underlying condition. As the number of sequelae codes is very limited, in the absence of an appropriate sequelae code, we suggest assigning Z87.6 Personal history of certain conditions arising in the perinatal period to describe a history of prematurity.
ACS 0001 Principal diagnosis applies to all patients and as such there is no age limit to the application of the Problems and underlying conditions part of standard, therefore it can be applied to a patient who is greater than 28 days. You must however have documentation of a condition clearly stated as being due to an underlying cause and the underlying cause still needs to be present.
ACS 0008 Sequelae provides guidance for coding the residual condition when the underlying cause is no longer present.
VICC does not consider the assignment of P07.22 Extreme immaturity, 24 or more completed weeks but less than 28 completed weeks is appropriate in the case cited because the prematurity is no longer present as an underlying condition. As the number of sequelae codes is very limited, in the absence of an appropriate sequelae code, we suggest assigning Z87.6 Personal history of certain conditions arising in the perinatal period to describe a history of prematurity.
