ICDcodes.org
FY2027

P04.9 — Newborn affected by maternal noxious substance, unspecified

BillableUnspecified

Is P04.9 billable?

Yes, but P04.9 is an unspecified code. P04.9 is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, P04.9 is an unspecified or catch-all code. Payers apply additional scrutiny to unspecified codes and many deny them when the medical record supports a more specific option, so check the documentation before selecting P04.9 — the more specific alternatives are listed below.

P04.9 at a glance

CodeP04.9
DescriptionNewborn affected by maternal noxious substance, unspecified
BillableYes
Code setICD-10-CM FY2027
Valid for encountersOctober 1, 2026 – September 30, 2027

Which MS-DRGs does P04.9 group to?

P04.9 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 P04.9 listed in the Alphabetic Index?

These are the routes through the Alphabetic Index that lead to P04.9. They show the wording a clinician may have documented, which often differs from the Tabular description.

  • Noxious › substances transmitted through placenta or breast milk
  • Absorption › chemical › through placenta
  • Newborn › affected by › noxious substances transmitted via placenta or breast milk (infant) (liveborn) (singleton)

Code first — inherited from P04

The underlying condition below must be sequenced before P04.9. P04.9 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 P04.9, but a patient may have both at the same time. When documentation supports it, P04.9 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 P04.9, but a patient may have both at the same time. When documentation supports it, P04.9 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 P04.9 existed?

P04.9 has been in ICD-10-CM since at least FY2016, the earliest fiscal year on record here.

Description changes
  • FY2018
    Newborn (suspected to be) affected by maternal noxious substance, unspecified
    Newborn affected by maternal noxious substance, unspecified

Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.

Which conditions are coded to P04.9?

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