ICDcodes.org
FY2027

P04.1 — Newborn affected by other maternal medication

Not billable

Is P04.1 billable?

No — P04.1 is a non-billable header code. P04.1 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 10 billable codes beneath P04.1.

P04.1 at a glance

CodeP04.1
DescriptionNewborn affected by other maternal medication
BillableNo — header code
Code setICD-10-CM FY2027
Valid for encountersOctober 1, 2026 – September 30, 2027

Excludes1 — never code together

The conditions below can never be reported together with P04.1 on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.

  • dysmorphism due to warfarin (Q86.2)
  • fetal hydantoin syndrome (Q86.1)

Code first

The underlying condition below must be sequenced before P04.1. P04.1 describes a manifestation and cannot be the principal or first-listed diagnosis.

  • , if applicable, withdrawal symptoms from maternal use of drugs of addiction (P96.1)
  • withdrawal symptoms from therapeutic use of drugs in newborn (P96.2)

Excludes2 — not included here

The conditions below are not part of P04.1, but a patient may have both at the same time. When documentation supports it, P04.1 and the excluded code may both be reported.

  • maternal anesthesia and analgesia in pregnancy, labor and delivery (P04.0)
  • maternal use of drugs of addiction (P04.4-)

Code first — inherited from P04

The underlying condition below must be sequenced before P04.1. P04.1 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 P04.1, but a patient may have both at the same time. When documentation supports it, P04.1 and the excluded code may both be reported.

  • 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)

Excludes2 — not included here — inherited from P04

The conditions below are not part of P04.1, but a patient may have both at the same time. When documentation supports it, P04.1 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.-)

What codes fall under P04.1? (10)

How long has P04.1 existed?

P04.1 has been in ICD-10-CM since at least FY2016, the earliest fiscal year on record here.

  • FY2019: P04.1 stopped being billable
Description changes
  • FY2018
    Newborn (suspected to be) affected by other maternal medication
    Newborn affected by other maternal medication

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 P04.1?

ICD-10-CM declares these codes mutually exclusive with P04.1 — exactly one of each pair can be correct for a given encounter.

What other codes are in the P04 family? (8)