P35.4 — Congenital Zika virus disease
Is P35.4 billable?
Yes — P35.4 is billable for FY2027. P35.4 is a valid, billable ICD-10-CM code at the highest level of specificity in its branch. P35.4 may be submitted for encounters from October 1, 2026 through September 30, 2027.
P35.4 at a glance
| Code | P35.4 |
|---|---|
| Description | Congenital Zika virus disease |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
Which MS-DRGs does P35.4 group to?
P35.4 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.
- 791Prematurity with Major Problemsmedical
As a secondary diagnosis, P35.4 is a major complication or comorbidity (MCC), which can move a stay into a higher-paying DRG.
How is P35.4 listed in the Alphabetic Index?
These are the routes through the Alphabetic Index that lead to P35.4. They show the wording a clinician may have documented, which often differs from the Tabular description.
- Zika NOS › congenital
- Disease, diseased › Zika virus › congenital
- Infection, infected, infective › Zika virus › congenital (opportunistic)
Use additional code
Report an additional code alongside P35.4 to fully describe the condition. P35.4 is sequenced first.
- code to identify manifestations of congenital Zika virus disease
Excludes2 — not included here — inherited from Chapter 16
The conditions below are not part of P35.4, but a patient may have both at the same time. When documentation supports it, P35.4 and the excluded code may both be reported.
Excludes2 — not included here — inherited from P35-P39
The conditions below are not part of P35.4, but a patient may have both at the same time. When documentation supports it, P35.4 and the excluded code may both be reported.
- asymptomatic human immunodeficiency virus [HIV] infection status (Z21)
- congenital gonococcal infection (A54.-)
- congenital pneumonia (P23.-)
- congenital syphilis (A50.-)
- human immunodeficiency virus [HIV] disease (B20)
- infant botulism (A48.51)
- infectious diseases not specific to the perinatal period (A00-B99, J09, J10.-)
- intestinal infectious disease (A00-A09)
- laboratory evidence of human immunodeficiency virus [HIV] (R75)
- tetanus neonatorum (A33)
How long has P35.4 existed?
P35.4 first appears in FY2019.
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 P35.4?
ICD-10-CM declares these codes mutually exclusive with P35.4 — exactly one of each pair can be correct for a given encounter.