P04.0 — Newborn affected by maternal anesthesia and analgesia in pregnancy, labor and delivery
Is P04.0 billable?
Yes — P04.0 is billable for FY2027. P04.0 is a valid, billable ICD-10-CM code at the highest level of specificity in its branch. P04.0 may be submitted for encounters from October 1, 2026 through September 30, 2027.
P04.0 at a glance
| Code | P04.0 |
|---|---|
| Description | Newborn affected by maternal anesthesia and analgesia in pregnancy, labor and delivery |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
Which MS-DRGs does P04.0 group to?
P04.0 sits in MDC 15 and helps define the logic of 1 MS-DRG (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.
- 794Neonate with Other Significant Problemsmedical
How is P04.0 listed in the Alphabetic Index?
These are the routes through the Alphabetic Index that lead to P04.0. They show the wording a clinician may have documented, which often differs from the Tabular description.
- Absorption › chemical › through placenta › obstetric anesthetic or analgesic drug
- Absorption › drug NEC › through placenta › obstetric anesthetic or analgesic drug
- Newborn › affected by › maternal › analgesia (infant) (liveborn) (singleton)
- Newborn › affected by › maternal › anesthesia (infant) (liveborn) (singleton)
- Newborn › affected by › maternal › tranquilizers administered for procedures during pregnancy or labor and delivery (infant) (liveborn) (singleton)
- Newborn › affected by › maternal › opiates › administered for procedures during pregnancy or labor and delivery (infant) (liveborn) (singleton)
Excludes2 — not included here
The conditions below are not part of P04.0, but a patient may have both at the same time. When documentation supports it, P04.0 and the excluded code may both be reported.
- newborn affected by other maternal medication (P04.1-)
Inclusion terms
Alternative wording in documentation that is classified to P04.0.
- Newborn affected by reactions and intoxications from maternal opiates and tranquilizers administered for procedures during pregnancy or labor and delivery
Code first — inherited from P04
The underlying condition below must be sequenced before P04.0. P04.0 describes a manifestation and cannot be the principal or first-listed diagnosis.
- any current condition in newborn, if applicable
Excludes2 — not included here — inherited from Chapter 16
The conditions below are not part of P04.0, but a patient may have both at the same time. When documentation supports it, P04.0 and the excluded code may both be reported.
Excludes2 — not included here — inherited from P04
The conditions below are not part of P04.0, but a patient may have both at the same time. When documentation supports it, P04.0 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.-)
How long has P04.0 existed?
P04.0 has been in ICD-10-CM since at least FY2016, the earliest fiscal year on record here.
- FY2018Newborn (suspected to be) affected by maternal anesthesia and analgesia in pregnancy, labor and deliveryNewborn affected by maternal anesthesia and analgesia in pregnancy, labor and delivery
Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.
Which codes are confused with P04.0?
ICD-10-CM declares these codes mutually exclusive with P04.0 — exactly one of each pair can be correct for a given encounter.
What other codes are in the P04 family? (8)
- 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