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Question: When I see documentation that says a newborn patient has apnea, is it always sleep apnea, like in adults?

Vermont Subscriber

Answer: Apnea is defined as an at least 20-second stoppage of respiratory airflow. There are several types of apnea that can affect newborns, including:

• Central apnea: Breathing stops due to poor or no muscle coordination
• Obstructive apnea: Breathing stops due to an obstruction in the airway
• Mixed apnea: Apnea caused by both central and obstructive conditions
• Sleep apnea: Symptoms occur during sleep

Coders can get pretty specific with diagnoses, with ICD-10-CM codes that require a 5^th character for newborn apnea conditions with P28.- (Other respiratory conditions originating in the perinatal period) codes:

• P28.30 (Primary sleep apnea of newborn, unspecified)
• P28.31 (Primary central sleep apnea of newborn)
• P28.32 (Primary obstructive sleep apnea of newborn)
• P28.33 (Primary mixed sleep apnea of newborn)
• P28.39 (Other primary sleep apnea of newborn)
• P28.40 (Unspecified apnea of newborn)
• P28.41 (Central neonatal apnea of newborn)
• P28.42 (Obstructive apnea of newborn)
• P28.43 (Mixed neonatal apnea of newborn)
• P28.49 (Other apnea of newborn)

You may see these conditions mentioned in documentation for patients who are currently newborns, but also for older patients. For example, providers may want to evaluate sleep disorders for patients with conditions like autism spectrum disorder. If they find that the patient is experiencing a type of apnea and determine that the condition originated during the perinatal period rather than as a result of obesity or other cause, then it may still be appropriate to use the aforementioned codes. ICD-10-CM Section I.C.16.a.1 Guidelines direct coders accordingly: “Chapter 16 codes may be used throughout the life of the patient if the condition is still present. “

Rachel Dorrell, MA, MS, CPC-A, CPPM, Development Editor, ÐÇ¿ÕÈë¿Ú