We are requesting clarification on the appropriate code assignment for “meconium passage during delivery” (763.84) and “meconium staining” (779.84). Coding Clinic Fourth Quarter 2005 states, “If medical record documentation only indicates that the newborn passed meconium during delivery assign code 763.84, Meconium passage during delivery. If meconium staining is documented without documentation of aspiration, assign code 779.84, Meconium staining, documented without documentation of aspiration.”
In this case, the provider documented, “Evidence of meconium passage before delivery. No laryngoscopy was performed because baby was vigorous at birth. We observed respiratory status closely during hospitalization.” How should meconium passage before delivery be coded?
ICD-9-CM does not provide a distinct code to differentiate between meconium passage occurring before or during delivery. Assign code 763.84, Meconium passage during delivery, for the newborn. The condition is considered clinically significant since it was being monitored and evaluated.
In this case, the baby had meconium-stained fluid. The provider documented, “Complications of delivery include: Pediatrics was called to delivery due to meconium-stained fluid. At birth, the infant was vigorous and crying. Direct laryngoscopy was not performed. Routine neonatal resuscitation program (NRP) was provided and no interventions were required.” Should meconium staining be coded in this instance since the condition was not treated?
Assign code 779.84, Meconium staining, for the newborn. The condition is clinically significant. When there is meconium staining at birth, the baby will be closely monitored for any sign of fetal distress.
The provider documented, “Complications of delivery include: Terminal meconium baby was vigorous. At risk for respiratory distress 2/2 meconium delivery will observe respiratory status closely.” How should “terminal meconium” be coded?
Assign code 763.84, Meconium passage during delivery, for the terminal meconium at birth. Terminal meconium passage during delivery is clinically significant. These infants are monitored since the condition can adversely affect newborns.