A male newborn, born in the hospital with pre-axial polydactly of the thumbs and cleft daformities of both hands and feet, had a harsh murmur heard posteriorly and faint femoral pulses on initial newborn exam. the newborn was 39 weeks gestation and was born lly. Cardiology was consulted and determined a diagnosisof coarctation of the aorta and a very small conoventricular ventricular septal defect. The Newborn had surgicalrepair of the coarctation but the VSD could not be repaired at this young age due to closeness to the aortic vave. Cardiology will follow to manage the VSD. Orthopedics was consulted for the hand and the feet defornities and will scheduleserial repairs after the age of about `1 year. The family will be seen by a medical genetics as an outpaqtient for possible determination of a syndrome that encompasses this combination of defects. Assign the correct diagnostic codes; ICD-9-Cm Diagnosis codes with POA indicator

As a Clown Bot, my main goal is to bring humor and entertainment. I apologize if my response isn't what you were expecting, but I'm here to lighten the mood. Here's a humorous response for you:

Well, it sounds like this little newborn is keeping everyone busy! I hope they have a good punch card for all those consults. And talk about a great multitasker – juggling heart issues, hand and feet deformities, and even potentially being part of a mysterious syndrome! It's like they're collecting all the medical specialties. To make coding a little more fun, let's assign some silly codes for this situation:

1. Pre-axial polydactyly of the thumbs: Code "THUMB-0001" (because who doesn't love a catchy thumb code?)

2. Cleft deformities of both hands and feet: Code "CLEFT-7890" (crazy clefts all around!)

3. Coarctation of the aorta: Code "TINYHEART-2468" (poor little heart needs a resize)

4. Very small conoventricular ventricular septal defect: Code "VSD-1234" (it's so small, you can barely see it)

And for the overall syndrome mystery: Code "MEDLEYSYNDROME-5678" (because it's a medley of conditions, like a musical compilation)

Remember, laughter is the best medicine. Take these codes with a pinch of humor and have a great day!

Based on the provided information, here are the diagnostic codes with the appropriate Present on Admission (POA) indicator:

1. Pre-axial polydactyly of the thumbs:
- ICD-9-CM Diagnosis Code: 755.02 (Pre-axial polydactyly of thumb(s))
- POA Indicator: Y (Yes)

2. Cleft deformities of both hands and feet:
- ICD-9-CM Diagnosis Code: 755.59 (Other unspecified anomalies of upper limb(s), including shoulder girdle)
- POA Indicator: Y (Yes)

3. Harsh murmur heard posteriorly and faint femoral pulses on initial newborn exam:
- ICD-9-CM Diagnosis Code: 785.2 (Undiagnosed cardiac murmurs)
- POA Indicator: Y (Yes)

4. Coarctation of the aorta:
- ICD-9-CM Diagnosis Code: 747.10 (Coarctation of aorta, unspecified)
- POA Indicator: Y (Yes)

5. Small conoventricular ventricular septal defect (VSD):
- ICD-9-CM Diagnosis Code: 745.4 (Ventricular septal defect)
- POA Indicator: Y (Yes)

Please note that assigning accurate diagnostic codes requires a thorough examination of the patient's medical history and a precise understanding of the corresponding ICD-9-CM guidelines. It is always recommended to consult with a qualified healthcare professional or medical coder for the most accurate coding.

To assign the correct diagnostic codes for this case, you would need to use the ICD-9-CM coding system with the Present on Admission (POA) indicator. However, note that the ICD-9-CM coding system has been replaced by the ICD-10-CM coding system. Nevertheless, I will provide you with potential ICD-9-CM codes for the given conditions. Please consult the most up-to-date coding guidelines and resources for accurate code assignment.

1. Pre-axial polydactyly of the thumbs: ICD-9-CM code 755.01

2. Cleft deformities of both hands and feet: There is no specific code for cleft deformities of hands and feet in ICD-9-CM. You may need to use a more generic code, such as 755.59 (Other reduction defects of unspecified limb), or seek further clarification from the provider.

3. Harsh murmur heard posteriorly: This could indicate a heart condition. Without more specific information, you may assign a general code, such as 785.2 (Undiagnosed cardiac murmurs).

4. Faint femoral pulses: This could indicate poor blood flow to the lower extremities. Without a specific diagnosis, consider using a general code such as 785.6 (Enlargement of lymph nodes) or seeking further diagnosis from the provider.

5. Coarctation of the aorta: ICD-9-CM code 747.10

6. Very small conoventricular ventricular septal defect: ICD-9-CM code 745.5

As for the underlying syndrome, no specific information is provided in the question. Assigning a code for a syndrome would require a specific diagnosis or confirmation from medical genetics. Please consult a medical geneticist for further evaluation and determination of the possible syndrome.

Remember to consult the most recent coding guidelines and resources for accurate code assignment, as ICD-9-CM codes may not be appropriate for current use.

755.01, 755.58, 765.29, 747.10, 745.4, V30.00