P04 — Newborn affected by noxious substances transmitted via placenta or breast milk
Is P04 billable?
No — P04 is a non-billable header code. P04 groups more specific codes and cannot be submitted on a claim. A valid ICD-10-CM code must be reported at the highest level of specificity available in its branch. Select one of the 22 billable codes beneath P04.
Billable codes under this header
- P04.0Newborn affected by maternal anesthesia and analgesia in pregnancy, labor and delivery
- P04.2Newborn affected by maternal use of tobacco
- P04.3Newborn affected by maternal use of alcohol
- P04.5Newborn affected by maternal use of nutritional chemical substances
- P04.6Newborn affected by maternal exposure to environmental chemical substances
- P04.9Newborn affected by maternal noxious substance, unspecified
- P04.11Newborn affected by maternal antineoplastic chemotherapy
- P04.12Newborn affected by maternal cytotoxic drugs
- P04.13Newborn affected by maternal use of anticonvulsants
- P04.14Newborn affected by maternal use of opiates
- P04.15Newborn affected by maternal use of antidepressants
- P04.16Newborn affected by maternal use of amphetamines
- P04.17Newborn affected by maternal use of sedative-hypnotics
- P04.1ANewborn affected by maternal use of anxiolytics
- P04.18Newborn affected by other maternal medication
- P04.19Newborn affected by maternal use of unspecified medication
- P04.40Newborn affected by maternal use of unspecified drugs of addiction
- P04.41Newborn affected by maternal use of cocaine
- P04.42Newborn affected by maternal use of hallucinogens
- P04.49Newborn affected by maternal use of other drugs of addiction
- P04.81Newborn affected by maternal use of cannabis
- P04.89Newborn affected by other maternal noxious substances
P04 at a glance
| Code | P04 |
|---|---|
| Description | Newborn affected by noxious substances transmitted via placenta or breast milk |
| Billable | No — header code |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
Code first
The underlying condition below must be sequenced before P04. P04 describes a manifestation and cannot be the principal or first-listed diagnosis.
- any current condition in newborn, if applicable
Excludes2 — not included here
The conditions below are not part of P04, but a patient may have both at the same time. When documentation supports it, P04 and the excluded code may both be reported.
- 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.-)
Includes
Conditions classified to P04.
- nonteratogenic effects of substances transmitted via placenta
Excludes2 — not included here — inherited from Chapter 16
The conditions below are not part of P04, but a patient may have both at the same time. When documentation supports it, P04 and the excluded code may both be reported.
What codes fall under P04? (9)
- P04.0Newborn affected by maternal anesthesia and analgesia in pregnancy, labor and delivery
- P04.1Newborn affected by other maternal medicationnot billable
- P04.2Newborn affected by maternal use of tobacco
- P04.3Newborn affected by maternal use of alcohol
- P04.4Newborn affected by maternal use of drugs of addictionnot billable
- P04.5Newborn affected by maternal use of nutritional chemical substances
- P04.6Newborn affected by maternal exposure to environmental chemical substances
- P04.8Newborn affected by other maternal noxious substancesnot billable
- P04.9Newborn affected by maternal noxious substance, unspecified
How long has P04 existed?
P04 has been in ICD-10-CM since at least FY2016, the earliest fiscal year on record here.
- FY2018Newborn (suspected to be) affected by noxious substances transmitted via placenta or breast milkNewborn affected by noxious substances transmitted via placenta or breast milk
Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.