P04 Newborn affected by noxious substances transmitted via placenta or breast milk

Not billable (header)Chapter 16

Report one of the more specific codes below.

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Codes under this one

P04.0 Newborn affected by maternal anesthesia and analgesia in pregnancy, labor and delivery
P04.1 Newborn affected by other maternal medicationHeader
P04.2 Newborn affected by maternal use of tobacco
P04.3 Newborn affected by maternal use of alcohol
P04.4 Newborn affected by maternal use of drugs of addictionHeader
P04.5 Newborn affected by maternal use of nutritional chemical substances
P04.6 Newborn affected by maternal exposure to environmental chemical substances
P04.8 Newborn affected by other maternal noxious substancesHeader
P04.9 Newborn affected by maternal noxious substance, unspecified

Instructional notes

Chapter 16

Excludes2Not included here: the patient may have both; report both when both are present.

congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)
endocrine, nutritional and metabolic diseases (E00-E88)
injury, poisoning and certain other consequences of external causes (S00-T88)
neoplasms (C00-D49)
tetanus neonatorum (A33)

Includes

conditions that have their origin in the fetal or perinatal period (before birth through the first 28 days after birth) even if morbidity occurs later

Notes

Codes from this chapter are for use on newborn records only, never on maternal records

Section P00-P04

Notes

These codes are for use when the listed maternal conditions are specified as the cause of confirmed morbidity or potential morbidity which have their origin in the perinatal period (before birth through the first 28 days after birth).

This code

Excludes2Not included here: the patient may have both; report both when both are present.

congenital malformations (Q00-Q99)
encounter for observation of newborn for suspected diseases and conditions ruled out (Z05.-)
neonatal jaundice from excessive hemolysis due to drugs or toxins transmitted from mother (P58.4)
newborn in contact with and (suspected) exposures hazardous to health not transmitted via placenta or breast milk (Z77.-)

Code firstSequence the underlying condition first.

any current condition in newborn, if applicable

Includes

nonteratogenic effects of substances transmitted via placenta

Chapter 16: Certain conditions originating in the perinatal period · P00-P04 Newborn affected by maternal factors and by complications of pregnancy, labor, and delivery (P00-P04)

Source: ICD-10-CM FY 2027 code descriptions and tabular list (CMS and CDC National Center for Health Statistics), effective 2026-10-01 through 2027-09-30 · CMS ICD-10 files. HCC mapping: CMS-HCC V28, payment year 2027. As of 2026-11-04.

Coverage and payment depend on the claim details; confirm with the Medicare Administrative Contractor.