Code R63.3, Feeding difficulties, has been expanded and several codes were created to separately classify feeding difficulties, unspecified (R63.30), pediatric feeding disorder, acute (R63.31), pediatric feeding disorder, chronic (R63.32) and other feeding difficulties (R63.39). Codes R63.31 and R63.32 are used for infants and children older than 28 days. However, if the feeding problem starts at birth and persists beyond the perinatal period, codes from category P92, Feeding problems of newborn, may be assigned with codes from subcategory R63. Any associated conditions (e.g., dysphagia, malnutrition) should also be coded, if applicable.
Pediatric feeding disorder (PFD) is defined as impaired oral intake that is not age-appropriate, and is associated with medical, nutritional, feeding skill, and/or psychosocial dysfunction. Patients with PFD can experience limitations, including not being able to feed effectively which leads to participation restrictions or modifications in childcare, school, and other environments involving mealtime interactions. PFDs can profoundly affect a child’s physical, social, emotional, and/or cognitive function, and increase caregiver stress.
Consistent with accepted norms, PFD can be classified into acute (< 3 months’ duration) and chronic (> 3 months’ duration). Acute PFD may be caused by medical conditions, such as esophagitis or a choking episode. Chronic PFD has myriad causes (e.g., gastroesophageal reflux, dysphagia, malnutrition, and psychosocial issues). As with other clinical conditions, it is the provider’s responsibility to document whether the PFD is acute or chronic. If the PFD is not specified as acute or chronic, code R63.30, Feeding difficulties, unspecified, should be assigned.
These new diagnosis codes will enable providers and researchers to better characterize pediatric feeding disorders, facilitate inclusion of all relevant disciplines in treatment planning, and allow the advancement of clinical research.
AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS - 2021 Issue 4; ICD-10-CM New/Revised Codes
Pediatric Feeding Disorder
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