P04.4

P04.4: Newborn affected by maternal use of drugs of addiction

Non-billable headerICD-10-CM

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

Not part of this code, but both may be coded when both are present.

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

Their own Excludes1 notes name this code, so the conflict is not listed above.

P93Reactions and intoxications due to drugs administered to newborn

Risk adjustment

No CMS-HCC V28 category: this code does not change a RAF score.

Code history

Unchanged in every release from FY2024 to FY2027.

Code to one of these instead P04.4

4 child codes. Green means billable.