2025 ICD-10-CM code Z05
(Active) Effective Date: N/A Revision Date: N/A Factors influencing health status and contact with health services - Persons encountering health services for examinations 21 Feed
Encounter for observation and evaluation of newborn for suspected diseases and conditions ruled out. This code applies to newborns in the neonatal period (first 28 days of life) suspected of having an abnormal condition, without signs or symptoms, which is ruled out after examination.
Medical necessity for using Z05 codes is established by the presence of a reasonable suspicion for a specific condition in a newborn, which requires evaluation to ensure the newborn's well-being. The documentation must support the suspicion and the subsequent ruling out of the condition.
The physician is responsible for examining the newborn, evaluating the suspected condition, and documenting the findings that led to the condition being ruled out.This typically includes a thorough physical examination and may involve additional diagnostic testing.
In simple words: This code is used when a newborn baby is checked for a suspected health problem, but after examination, the doctor finds that the baby is healthy.
This ICD-10-CM code (Z05) is used for newborns within the first 28 days of life who are suspected of having an abnormal condition but do not present any signs or symptoms.After examination and observation, the suspected condition is ruled out.This code should not be used if signs or symptoms are present; instead, the code for the specific sign or symptom should be reported.
Example 1: A newborn is evaluated for suspected respiratory distress due to maternal opioid use, but after observation, the infant's breathing is normal, and the condition is ruled out (Z05.3)., A newborn is examined for a suspected cardiac condition due to a family history of heart defects. After examination and monitoring, no cardiac abnormalities are found (Z05.0)., A newborn is observed for suspected hypoglycemia, but after glucose monitoring, the levels are consistently within the normal range (Z05.1).
Documentation should clearly state the suspected condition, the basis for the suspicion (e.g., family history, maternal factors), the examination performed, and the results that led to the condition being ruled out. Any additional tests performed should also be documented.
** The Z05 category provides a way to track and analyze the evaluation of newborns for suspected conditions, even when those conditions are ultimately ruled out. This data can be useful for public health surveillance and quality improvement initiatives.
- Specialties:Pediatrics, Neonatology, Family Medicine
- Place of Service:Inpatient Hospital, Office