R68.13
Apparent life threatening event in infant (ALTE)
Clinical Classification Guidelines
Use Additional Code
- code(s) for associated signs and symptoms if no confirmed diagnosis established, or if signs and symptoms are not associated routinely with confirmed diagnosis, or provide additional information for cause of ALTE
Inclusion Terms
- Apparent life threatening event in newborn
- Brief resolved unexplained event (BRUE)
Code First
- confirmed diagnosis, if known
Medical Intelligence & Overview
An Apparent Life Threatening Event (ALTE) in infants is characterized by a sudden episode that appears dangerous and involves symptoms like breathing issues, color changes, or unconsciousness. These episodes can be alarming for caregivers, but with appropriate understanding and management, many infants recover fully. Recently, medical professionals have also referred to similar events as Brief Resolved Unexplained Events (BRUE), emphasizing their temporary nature and the lack of an immediately obvious cause. Recognizing these events and understanding their nuances are vital for caregivers and healthcare providers to ensure infant safety and proper follow-up care.
Causes & Symptoms
Clinical Causes: Respiratory infections (such as bronchiolitis or pneumonia) Gastroesophageal reflux (acid reflux causing airway irritation) Seizures or neurological disorders Cardiac abnormalities or arrhythmias Metabolic imbalances (like hypoglycemia or electrolyte disturbances) Apnea of prematurity in preterm infants Environmental factors (exposure to smoke, or choking hazards) Immature or malfunctioning respiratory control centers in the brain
Key Symptoms: Cyanosis (bluish color of the lips, face, or extremities) Irregular or paused breathing (apnea) Sudden limpness or loss of muscle tone Change in skin color (pale or bluish tone) Choking, gagging, or coughing during the episode Change in responsiveness or unresponsiveness Altered heart rate (either too fast or too slow) Brief episodes lasting less than a minute, but potentially recurrent
Diagnostic & Treatment
Diagnosis Path: Diagnosing ALTE involves a thorough clinical history and physical examination, focusing on the circumstances leading up to the event. Healthcare providers may recommend various tests, including:
Treatment Protocols: Treatment strategies depend on the underlying cause identified during evaluation. Common approaches include:
Clinical Advice & FAQs
Billing Guidance
Is R68.13 a billable ICD-10 code?
Yes, R68.13 is a specific, billable code that can be used to indicate a diagnosis for reimbursement purposes.
Documentation
How do I report R68.13?
Clinical documentation must specify the nature of Apparent life threatening event in infant (ALTE) and any associated comorbidities for accurate reporting.
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