ICD Code R62.51

ICD code R62.51 is used to identify and classify the condition known as "Failure to thrive" in children. This code is applied when a child is not gaining weight or growing as expected, which can be due to a variety of underlying medical, nutritional, or environmental factors. It is important for healthcare providers to accurately document this condition using the ICD code R62.51 to ensure appropriate diagnosis, treatment planning, and reimbursement processes within the healthcare revenue cycle.

1. Inadequate Weight Gain: The child consistently fails to gain weight at the expected rate for their age and growth percentile, often falling below the 5th percentile on standardized growth charts.

2. Poor Feeding Habits: The child exhibits difficulties with feeding, such as refusing to eat, eating very little, or having prolonged feeding times that do not result in adequate nutritional intake.

3. Delayed Developmental Milestones: The child shows delays in reaching age-appropriate developmental milestones, such as sitting, crawling, or walking, which may be associated with insufficient nutrition.

4. Chronic Diarrhea or Constipation: The child experiences persistent gastrointestinal issues that may contribute to poor nutrient absorption and inadequate growth.

5. Recurrent Infections: The child has frequent infections, which may indicate a compromised immune system due to malnutrition.

6. Muscle Wasting or Loss of Subcutaneous Fat: The child presents with visible signs of muscle wasting or a noticeable decrease in subcutaneous fat, indicating a lack of adequate nutrition.

7. Behavioral Changes: The child may exhibit irritability, lethargy, or a lack of interest in their surroundings, which can be associated with nutritional deficiencies.

8. Medical History and Family Dynamics: Consideration of the child's medical history, including any chronic illnesses, and an assessment of family dynamics that may impact the child's nutritional status.

9. Laboratory Findings: Abnormal laboratory results that suggest malnutrition or underlying medical conditions contributing to poor growth.

10. Comprehensive Evaluation: A thorough evaluation by healthcare professionals, including pediatricians and nutritionists, to rule out other medical conditions and confirm the diagnosis of failure to thrive.

For the ICD code R62.51 (Failure to thrive in a child), relevant CPT codes that may be applicable for treatment and management include:

1. 99201-99215: Evaluation and Management (E/M) services for new or established patients, which may include history, examination, and medical decision-making.

2. 99381-99385: Initial comprehensive preventive medicine evaluation and management of an individual, including an age and gender-appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures for new patients.

3. 99391-99395: Periodic comprehensive preventive medicine reevaluation and management of an individual, including an age and gender-appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures for established patients.

4. 99401-99404: Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure).

5. 99460-99463: Initial and subsequent hospital or birthing center care for evaluation and management of normal newborn infant.

6. 99468-99476: Critical care services for the evaluation and management of critically ill neonates and infants.

7. 96110: Developmental screening, with interpretation and report, per standardized instrument form.

8. 96127: Brief emotional/behavioral assessment (e.g., depression inventory, attention-deficit/hyperactivity disorder [ADHD] scale), with scoring and documentation, per standardized instrument.

These CPT codes are examples of the types of services that may be provided to address the condition associated with ICD code R62.51. The specific codes used will depend on the individual patient's needs and the healthcare provider's clinical judgment.

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