• Commonly Reported ICD-10-CM Codes Related to Breastfeeding

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    BABY

    ICD-10-CM Codes

    Feeding Problems

    Bilious vomiting of newborn P92.01
    Other vomiting of newborn P92.09
    Regurgitation and rumination of newborn P92.1
    Slow feeding of newborn P92.2
    Underfeeding of newborn P92.3
    Neonatal difficulty in feeding at breast P92.5
    Other feeding problems of newborn P92.8
    Feeding problem of newborn, unspecified P92.9
    Vomiting, unspecified (>28 days old) R11.10
    Projectile vomiting (>28 days old) R11.12
    Bilious vomiting (>28 days old) R11.14

    Jaundice

    Neonatal jaundice associated with preterm delivery P59.0
    Neonatal jaundice from breast milk inhibitor P59.3
    Neonatal jaundice from other specified causes P59.8
    Neonatal jaundice, unspecified P59.9

    Weight and Hydration

    Dehydration of newborn P74.1
    Disturbances of sodium balance of newborn P74.2
    Disturbances of potassium balance of newborn P74.3
    Failure to thrive in newborn P92.6
    Failure to thrive in child over 28 days old R62.51
    Abnormal weight loss R63.4
    Abnormal weight gain R63.5
    Underweight R63.6

    Infant Distress

    Excessive crying of infant (baby) R68.11
    Fussy infant (baby) R68.12
    Colic R10.83

    Gastrointestinal Issues

    Change in bowel habit R19.4
    Other fecal abnormalities R19.5
    Diarrhea, unspecified R19.7
    Other specified symptoms and signs involving the
    digestive system and abdomen
    R19.8

    Mouth

    Ankyloglossia Q38.1
    Congenital malformations of palate (high arched palate) Q38.5
    Other
    Encounter for follow-up examination after completed treatment Z09

     

    Billing for the Infant’s Mother

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    The medical provider may bill for the mother if s/he takes the mother’s history, examines the mother’s breasts and nipples, observes a feeding and makes a diagnosis and treatment plan for her.

    The mother’s insurance may require a request from her primary health care provider. The mother may be billed as either a new patient visit or a consult (99241-99245), if you have a request and provide a written report back to the requestor.

    MOTHER

    ICD-10-CM Codes

    Breast & Nipple Issues

    Candidiasis, breast or nipple B37.89
    Impetigo, unspecified L01.00
    Infection of nipple associated with the puerperium O91.02
    Infection of nipple associated with lactation O91.03
    Abscess of breast associated with lactation/Mastitis purulent O91.13
    Nonpurulent mastitis associated with lactation O91.23
    Retracted nipple associated with lactation O92.03
    Cracked nipple associated with lactation O92.13
    Other congenital malformations of breast (ectopic or axillary breast tissue) Q83.8
    R20.3 Hyperesthesia (burning) R20.3

    Constitutional

    Circadian rhythm sleep disorder, irregular sleep wake type G47.23
    Sleep disorder, unspecified G47.9
    Fatigue R53.83

    Lactation

    Agalactia O92.3
    Hypogalactia O92.4
    Suppressed lactation O92.5
    Galactorrhea O92.6
    Unspecified disorders of lactation O92.70
    Galactocele (Other disorders of lactation) O92.79
    Encounter for care and examination of lactating mother
    (Excludes encounter for conditions related to O92.-)
    Z39.1

    Other

    Encounter for follow-up examination after completed treatment
    (When the original reason for visit has resolved)
    Z09

    ^Do not use any codes listed under the mother for the baby’s medical record

    For more detailed information about coding for breastfeeding management, please consult the American
    Academy of Pediatrics’ Supporting Breastfeeding and Lactation: The Primary Care Pediatrician’s Guide to Getting Paid