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2025 ICD-10-CM code P78.84

Gestational alloimmune liver disease (GALD) or neonatal hemochromatosis in newborns.

Code P78.84 should only be used for newborns (0-28 days old) and only if the diagnosis is specifically documented.It's not used for maternal records or for other forms of hemochromatosis.

Medical necessity is established through clinical findings consistent with GALD, which includes abnormal liver function tests, elevated iron levels, and positive maternal antibody screening. Documentation must support the diagnosis and justify the medical interventions.

The clinical responsibility for managing a newborn with P78.84 lies with the neonatologist or pediatrician.This includes diagnosing the condition, monitoring its progression, and providing appropriate treatment, such as blood transfusions or chelation therapy.

IMPORTANT:No specific alternate codes are listed; however, depending on the specific presentation, other codes within Chapter 16 might be relevant if the primary manifestation isn't liver-specific.Careful clinical documentation is vital.

In simple words: This code describes a liver problem in babies caused by the mother's body attacking the baby's liver before or shortly after birth.It sometimes leads to iron overload in the baby. This code is only for babies' medical records.

P78.84, Gestational alloimmune liver disease (GALD), is an ICD-10-CM code representing a specific type of liver disease affecting newborns.It's characterized by liver damage resulting from maternal antibodies attacking the fetal liver.This can manifest as neonatal hemochromatosis, a condition marked by iron overload in the newborn's body.The code is exclusively for use in newborn records and should not be applied to maternal records. The condition's origin lies in the perinatal period (before birth through the first 28 days after birth), even if clinical manifestations arise later in life.This code is used only if the specific diagnosis is explicitly documented.It excludes other types of hemochromatosis and conditions with similar symptoms not directly linked to maternal alloimmune processes.

Example 1: A newborn presents with jaundice, hepatomegaly, and elevated liver enzymes. Further investigation reveals elevated iron levels and positive maternal antibodies, leading to a diagnosis of GALD., A baby born prematurely shows signs of liver dysfunction shortly after birth.Testing confirms the presence of maternal antibodies targeting the fetal liver, confirming the diagnosis and necessitating close monitoring for potential iron overload., A full-term infant develops progressive liver disease in the first few weeks of life. Genetic testing is negative for common causes of neonatal liver disease;however, the presence of maternal antibodies and elevated iron levels point to GALD. This scenario highlights that clinical presentation may not be immediate, underlining the importance of thorough investigation.

Detailed maternal history including prenatal care records, presence of any maternal antibodies or related conditions, and results of newborn's liver function tests, iron studies, and genetic screening (if performed).Complete documentation of clinical examination findings, treatment plans, and response to therapy.

** The diagnosis of P78.84 requires a high degree of clinical suspicion and confirmation through appropriate laboratory testing. The condition is rare.Close collaboration between the neonatologist and maternal healthcare providers is essential for appropriate management.

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