AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS - 2018 Issue 2; Ask the Editor

Newborn Disturbance of Sodium Balance

Please clarify the appropriate code assignment for an infant in the perinatal period, who develops either hyponatremia or hypernatremia. There is an Excludes2 note at the beginning of Chapter 16, Certain conditions originating in the Perinatal Period (P00-P96), indicating these codes can be assigned with a code from Chapter 4, Endocrine, nutritional and metabolic disease (E00-E89). However, at the beginning of Chapter 4 there is an Excludes1 note that does not allow assigning codes in categories E00-E89 with codes in categories P70-P74. Based on these conflicting Excludes notes, would code P74.2, Disturbances of sodium balance of newborn, be assigned with either code E87.0, Hyperosmolality and hypernatremia, or code E87.1, Hypo-osmolality and hyponatremia, to further specify the condition? ...

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