ICDwise
P04 ⚠ Non-billable

Newborn affected by noxious substances transmitted via placenta or breast milk

ICD-10-CM · FY2026 · Certain Conditions Originating in the Perinatal Period

Code
P04
System
ICD-10-CM
Billable
No — use specific code
Effective
FY2026
Chapter
Certain Conditions Originating in the Perinatal Period
Source
CMS / CDC NCHS
⚠ Verify before billing. Confirm against the current CMS/NCHS ICD-10-CM files and your payer's rules before claims submission.

Official coding notes

From CMS's ICD-10-CM Tabular List.

Includes
  • nonteratogenic effects of substances transmitted via placenta
Excludes2 — not included here, but may code together
  • 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.-)
Code first
  • any current condition in newborn, if applicable

Frequently asked questions

What is ICD-10 code P04?
ICD-10-CM code P04 represents Newborn affected by noxious substances transmitted via placenta or breast milk. It is a non-billable header code requiring a more specific subcategory in the Certain Conditions Originating in the Perinatal Period chapter, effective October 1, 2025 – September 30, 2026.
Is P04 billable?
No. P04 is a non-billable header. Select a more specific subcategory for claims submission.
What chapter is P04 in?
P04 belongs to the Certain Conditions Originating in the Perinatal Period chapter (P00–P96) of ICD-10-CM.

Related codes in the P04 category

P04.0 Newborn affected by maternal anesthesia and analgesia in pregnancy, labor and delivery Billable P04.1 Newborn affected by other maternal medication Non-billable P04.2 Newborn affected by maternal use of tobacco Billable P04.3 Newborn affected by maternal use of alcohol Billable P04.4 Newborn affected by maternal use of drugs of addiction Non-billable P04.5 Newborn affected by maternal use of nutritional chemical substances Billable P04.6 Newborn affected by maternal exposure to environmental chemical substances Billable P04.8 Newborn affected by other maternal noxious substances Non-billable

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