Neonatal metabolic disturbances are transitory conditions that occur during birth or shortly thereafter. New codes were created to identify metabolic disturbances in the major serum electrolytes (sodium, potassium, chloride and bicarbonate) that are specific to the newborn. These new codes also differentiate hyper- and hyponatremia, and hyper- and hypokalemia.
These conditions have different etiologies, consequences, and treatment with potential for a different level of urgency. Fluid management is an important component of treatment and varies greatly between these conditions. Medications may also be given depending on which condition is present. Newborns may experience both hyper- and hyponatremia or hyper- and hypokalemia during the same hospital stay; the same is true for high or low serum chloride and bicarbonate concentrations.
The American Academy of Pediatrics requested the addition of new codes in category P74, Other transitory neonatal electrolyte and metabolic disturbances, to specifically identify these metabolic disturbances.
The new codes are as follows: