P04.4 — Newborn affected by maternal use of drugs of addiction
P04.4 is a non-billable header ICD-10-CM code for newborn affected by maternal use of drugs of addiction. It cannot be billed on its own: choose one of the more specific child codes below.
Excludes2 inherited from the categories above P04.4
Also inherited, and the opposite of Excludes1: these conditions are not part of P04.4, 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.-)
Other codes that can never be billed with P04.4
These codes carry an Excludes1 note pointing at P04.4. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading P04.4 alone.
- P93Reactions and intoxications due to drugs administered to newborn
Risk adjustment
P04.4 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.
Code history
P04.4 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.
Code to one of these instead P04.4
4 child codes. Green means billable.
Related codes at this level
Codes that share P04. If P04.4 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
- P04.2Newborn affected by maternal use of tobacco
- P04.3Newborn affected by maternal use of alcohol
- 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 P04.4
- Is P04.4 a billable ICD-10-CM code?
- No. P04.4 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
- Where does P04.4 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).