Janury 22, 2007

Coding for Sudden Infant Death Syndrome
For The Record
Vol. 19 No. 1 P. 33

Sudden infant death syndrome (SIDS) is the death of a seemingly healthy infant with no known cause. The unexpected death rarely occurs in an infant before 2 weeks of age or after 6 months and typically occurs between 2 to 4 months. Worldwide, three of every 2,000 infants are affected by SIDS.

Risk Factors
The following factors can increase an infant’s risk of being affected by SIDS:

• male;

• between 2 weeks and 6 months old;

• premature or low birthweight (under 4.4 pounds);

• African American or American Indian;

• sleeps on stomach;

• mother smokes or uses drugs;

• exposure to tobacco smoke;

• mother with placenta previa;

• winter months; and

• low-income families.

To help reduce the risk, infants should sleep on a firm mattress without thick, fluffy padding and should avoid sleeping in an adult’s bed which may increase suffocation risk. In addition, the use of a pacifier may reduce SIDS risk.

Coding Information
SIDS is classified to International Classification of Diseases, Ninth Revision, Clinical Modification code 798.0. Code 798.0 also includes the following terms:

• cot death;

• crib death; and

• sudden death of nonspecific cause in infancy.

If an infant is admitted with symptoms of SIDS but is revived, assign code 770.89, Respiratory problems after birth. According to AHA Coding Clinic for ICD-9-CM, 1996, second quarter, pages 10-11, assign a code for the individual symptoms that are present at the time of admission for infants admitted with the following diagnoses:

• apparent life-threatening event;

• aborted SIDS;

• near miss SIDS; and

• pending SIDS.

Some common symptoms occurring in these infants include the following:

• Primary apnea of newborn (770.81);

• Obstructive apnea of newborn (770.82);

• Hypoxemia of newborn (770.88);

• Respiratory distress of newborn (770.89);

• Respiratory arrest of newborn (770.87);

• Respiratory failure of newborn (770.84);

• Respiratory distress syndrome (769);

• Transitory tachypnea of newborn (770.6)

• Respiratory distress or insufficiency—not of newborn (786.09); and

• Shock (785.50).

Other sudden death codes not necessarily of infants include the following:

• Instantaneous death (798.1)

• Death occurring within less than 24 hours of onset of symptoms, not otherwise explained (798.2)

- Death known not to be violent or instantaneous, for which no cause could be discovered

- Death without sign of disease

• Unattended death (798.9)

- Death in circumstances where the body of the deceased was found and no cause could be discovered

- Found dead

Coding and sequencing for SIDS are dependent on the physician documentation in the medical record and application of the Official Coding Guidelines for inpatient care. Also, use specific AHA Coding Clinic for ICD-9-CM and American Medical Association CPT Assistant references to ensure complete and accurate coding.

— This information was prepared by Audrey Howard, RHIA, of 3M Consulting Services. 3M Consulting Services is a business of 3M Health Information Systems, a supplier of coding and classification systems to nearly 5,000 healthcare providers. The company and its representatives do not assume any responsibility for reimbursement decisions or claims denials made by providers or payers as the result of the misuse of this coding information. More information about 3M Health Information Systems is available at www.3mhis.com or by calling 800-367-2447.