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2025 ICD-10-CM code P59.9

Neonatal jaundice, unspecified.This code is used when the cause of neonatal jaundice is unknown or not specified.

Coding guidelines for P59.9 include ensuring that a more specific code from the P59 range isn't appropriate based on clinical findings and medical documentation.If the cause of the jaundice is identifiable, use that more specific code. This code should only be used for newborns (first 28 days of life).

Not applicable to ICD-10 codes.

Medical necessity for coding P59.9 is established by the presence of clinically significant jaundice in a newborn, requiring evaluation and management. This evaluation usually includes the physician's assessment, laboratory testing for bilirubin levels, and the clinical judgment as to the severity and need for intervention, such as phototherapy or other treatments.

The clinical responsibility lies with the physician or healthcare professional who diagnoses and manages the newborn's jaundice. This includes ordering laboratory tests (bilirubin levels), conducting physical examinations, and potentially referring to specialists if needed.

IMPORTANT:If the cause of the neonatal jaundice is known (e.g., prematurity, breast milk inhibitor), more specific codes from the P59 category (P59.0-P59.8) should be used instead.Avoid using this code if a more specific diagnosis is possible.E80.6 (Other disorders of bilirubin metabolism) is not appropriate for neonatal jaundice.

In simple words: This code means a baby has jaundice (yellowing of the skin and eyes) but doctors don't know why. This code is only used for newborns in their first month of life.

This ICD-10-CM code, P59.9, signifies neonatal jaundice where the underlying cause remains unspecified or is not documented.It is used when a newborn exhibits jaundice, but the specific reason (e.g., prematurity, breast milk incompatibility, hepatocellular damage) cannot be definitively determined from the available medical records. This code is applicable only to newborns within the first 28 days of life.The diagnosis should be supported by clinical findings such as elevated bilirubin levels and physical examination.

Example 1: A newborn is admitted to the hospital on day 2 of life due to visible jaundice.Lab tests confirm elevated bilirubin levels but further investigations (e.g., blood type, liver function tests) do not reveal a specific cause.Code P59.9 is used., A preterm infant (34 weeks gestation) presents with mild jaundice at day 10.While prematurity is a contributing factor, the jaundice is not severe and no specific cause is identified beyond prematurity. P59.9 is used, as the prematurity is documented in a separate code., A full-term infant develops jaundice on day 5.After comprehensive testing including blood work, imaging studies, and specialist consultations, the cause is not determined.P59.9 is assigned as the definitive code.

Complete and detailed medical records are crucial for accurate coding.Documentation should include the newborn's gestational age, birth weight, clinical presentation (jaundice onset, severity, other symptoms), lab results (bilirubin levels, other relevant blood tests), and any investigations performed to determine the cause of jaundice.The absence of specific findings supporting other codes from P59 justifies the use of P59.9.

** The use of P59.9 necessitates thorough documentation to justify the lack of a more specific diagnosis.Documentation should clearly state the investigations performed and the reasons for not assigning a more specific code from P59.0-P59.8.Consider any potential underlying conditions.Always cross-reference with current ICD-10-CM guidelines for the most up-to-date information.

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