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2025 ICD-10-CM code Z05.0

Observation and evaluation of newborn for suspected cardiac condition ruled out.

A Z code should not be used as a primary diagnosis. Z05.0 is specifically for use in newborns within the first 28 days of life.If a procedure is performed, a corresponding procedure code must accompany the Z code.If signs or symptoms are present, codes for the signs or symptoms should be reported instead of Z05.0. Do not use codes from categories P00-P04 for suspected conditions ruled out in newborns.

Medical necessity must be established by documenting the signs, symptoms, or risk factors that led to the suspicion of a cardiac condition. The documentation must support the need for the observation and evaluation to rule out a potentially serious condition.

The physician is responsible for the examination and observation of the newborn, including assessment of vital signs, physical examination, and any necessary diagnostic tests, to determine whether a suspected cardiac condition is present or ruled out. The physician must document the findings that led to the suspected cardiac condition, the evaluation performed, and the results that ruled out the condition.

In simple words: A newborn was checked for a possible heart problem, but after being examined, it was determined there was no problem.

This code is used for the observation and evaluation of a newborn for a suspected cardiac condition that has been ruled out after examination.

Example 1: A newborn is observed for a suspected heart murmur, but after examination and an echocardiogram, the murmur is determined to be innocent., A newborn born to a mother with gestational diabetes is monitored for possible cardiomyopathy, but after observation and testing, no cardiac abnormality is found., A newborn with an irregular heartbeat is observed for possible congenital heart defect, but further testing reveals no structural or functional heart abnormalities.

Documentation should include the reason for the observation, the details of the examination, the results of any diagnostic tests performed (e.g., echocardiogram, EKG), and the final determination that the suspected cardiac condition was ruled out.

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