P04.2 — Newborn affected by maternal use of tobacco
P04.2 is a billable, specific ICD-10-CM code for newborn affected by maternal use of tobacco. It is valid for submission on a claim.
Excludes2 — not included here, but may coexist
The excluded condition is not part of this code, but a patient can have both. You may code both.
- newborn exposure to environmental tobacco smoke (P96.81)
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Newborn affected by exposure in utero to tobacco smoke
Excludes2 inherited from the categories above P04.2
Also inherited, and the opposite of Excludes1: these conditions are not part of P04.2, but a patient can have both, so you may code both.
Written on P04 — Newborn affected by noxious substances transmitted via placenta or breast milk
- 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.-)
Risk adjustment
P04.2 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 137 Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications0.424 RAF
Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score.
How P04.2 is indexed
Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to P04.2.
- Tobacco›maternal use, affecting newborn
- Newborn›affected by›tobacco
Code history
P04.2 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.
Related codes at this level
Codes that share P04. If P04.2 is not quite right, the correct code is usually one of these.
- P04.0Newborn affected by maternal anesthesia and analgesia in pregnancy, labor and delivery
- P04.1Newborn affected by other maternal medication
- P04.3Newborn affected by maternal use of alcohol
- P04.4Newborn affected by maternal use of drugs of addiction
- 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 substances
- P04.9Newborn affected by maternal noxious substance, unspecified
Questions about P04.2
- Is P04.2 a billable ICD-10-CM code?
- Yes. P04.2 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does P04.2 sit in the tabular list?
- Certain conditions originating in the perinatal period (P00-P96), in the block Newborn affected by maternal factors and by complications of pregnancy, labor, and delivery (P00-P04).