2025 ICD-10-CM code P23.6
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Perinatal Conditions - Respiratory and cardiovascular disorders specific to the perinatal period (P19-P29) Certain conditions originating in the perinatal period (P00-P96) Feed
Congenital pneumonia due to other bacterial agents.
Medical necessity for coding P23.6 is established by the presence of clinical signs and symptoms consistent with pneumonia, such as respiratory distress, cough, and fever, and confirmed by laboratory findings indicating bacterial infection. Prematurity, low birth weight, and other risk factors also contribute to medical necessity.
Diagnosis and treatment of neonatal pneumonia.This may involve respiratory support, antibiotics, and monitoring of the newborn's condition.
In simple words: This code is for babies born with pneumonia caused by bacteria.The pneumonia started before birth or during delivery.
This code classifies congenital pneumonia caused by bacterial agents other than those specifically listed elsewhere.It includes infective pneumonia acquired in utero or during birth.It excludes neonatal pneumonia resulting from aspiration.
Example 1: A newborn presents with respiratory distress shortly after birth.Cultures reveal the presence of an unspecified bacterial pathogen consistent with pneumonia.The attending neonatologist diagnoses congenital pneumonia due to other bacterial agents (P23.6)., A premature infant is diagnosed with pneumonia during the first week of life, exhibiting symptoms of tachypnea, grunting, and nasal flaring.Bacterial cultures are inconclusive as to specific pathogens.The attending physician codes the case as P23.6., A full-term baby exhibits signs of congenital pneumonia within 28 days of life; investigations show that this is due to a bacterium not specified in other P23 codes. The condition is coded as P23.6.
** This code should be used cautiously, only when the causative bacteria cannot be further specified using other more specific codes within the P23 category. Thorough documentation is crucial for proper coding and reimbursement.
- Payment Status: Active
- Specialties:Neonatology, Pediatrics
- Place of Service:Inpatient Hospital