2025 ICD-10-CM code P09.4
Abnormal findings on neonatal screening for cystic fibrosis.
Not applicable.
Medical necessity is established by the positive newborn screening results, indicating the need to confirm or rule out cystic fibrosis. Early diagnosis and intervention significantly improve outcomes for affected infants.
The responsibility for using this code and managing the patient's care rests with the healthcare provider, typically a neonatologist or pediatrician, attending to the newborn.
- Certain conditions originating in the perinatal period (P00-P96)
- Abnormal findings on neonatal screening (P09-P09)
In simple words: A newborn's screening test showed a possibility of cystic fibrosis, but more tests are needed to be sure.
Abnormal findings on neonatal screening for cystic fibrosis. This code is specific for abnormal newborn screening results suggestive of cystic fibrosis and requires further confirmatory testing.
Example 1: A newborn's initial screening reveals an elevated immunoreactive trypsinogen (IRT) level, prompting further investigation for cystic fibrosis using genetic testing and a sweat chloride test., A newborn's genetic test detects one or more mutations associated with cystic fibrosis, requiring confirmatory testing, even if the IRT levels are normal., A newborn displays symptoms suggestive of cystic fibrosis, such as meconium ileus, alongside abnormal screening results, leading to immediate diagnostic testing and specialist consultations.
Documentation should include results of the newborn screening tests (IRT and genetic tests), subsequent sweat chloride test results, and any specialist consultations (e.g., geneticist, pulmonologist).
** This code represents a preliminary finding and does not necessarily indicate a definitive diagnosis. Confirmatory testing, such as the sweat chloride test, is essential.
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Specialties:Neonatology, Pediatrics, Pulmonology, Genetics
- Place of Service:Inpatient Hospital, Birthing Center