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