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2025 ICD-10-CM code P08.1

Other heavy for gestational age newborn.Birth weight between 4000g and 4499g.

This code is specifically for use on the newborn's medical record, not the mother's record. If the baby's weight is 4500g or more P08.0 (Exceptionally large baby) should be used.When both birth weight and gestational age are available, prioritize the birth weight for code assignment. Do not use this code for infants of diabetic mothers or mothers with gestational diabetes. Use codes P70.1 and P70.0 instead.

Medical necessity for this code usually hinges on the potential complications associated with being large for gestational age. This can include birth injuries, difficulty with delivery, or the need for additional monitoring or care.

Assessment and documentation of newborn's weight and gestational age are crucial for applying this code. Healthcare providers responsible for newborn care, such as pediatricians or neonatologists, typically assign this code.

In simple words: This code describes a newborn baby that is considered larger than average for their gestational age, with a birth weight typically between 4000 and 4499 grams. It is used when the baby's size is not related to specific conditions like being born to a mother with diabetes.

Other heavy for gestational age newborn. Other newborn heavy- or large-for-dates regardless of period of gestation. Usually implies a birth weight of 4000 g. to 4499 g.

Example 1: A newborn delivered at 39 weeks gestation weighs 4250 grams.All other clinical findings are normal. P08.1 is assigned., A baby born at 41 weeks weighs 4300g. The mother did not have diabetes during pregnancy. Other than the higher birth weight the baby is otherwise healthy. P08.1 is the appropriate code., Twins are delivered at 38 weeks. Twin A weighs 2800g and Twin B weighs 4100g.There is no documentation to explain why there is a weight discrepancy. Code P08.1 would be applied for Twin B.

Documentation must include the newborn's birth weight and gestational age at delivery. Any other conditions present should also be documented. This information is essential for accurate coding and may be used to justify medical necessity for additional care if required.

** This diagnosis code is assigned to newborns to facilitate tracking of outcomes and potential complications related to their size at birth. It is an important factor in newborn care management and resource allocation.

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