P04.9

P04.9: Newborn affected by maternal noxious substance, unspecified

Billable / specific codeICD-10-CM

P04.9 is a billable, specific ICD-10-CM code for newborn affected by maternal noxious substance, unspecified. It is valid for submission on a claim.

Check P04.9 with the rest of the claim: free scrubber

Excludes2 inherited from the categories above P04.9

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.-)

Risk adjustment

P04.9 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. Look up the whole chart to see which of its HCCs the hierarchy would zero.

Alphabetic index entries that lead here

Noxious›substances transmitted through placenta or breast milk
Absorption›chemical›through placenta(newborn)
Newborn›affected by›noxious substances transmitted via placenta or breast milk

Code history

Unchanged in every release from FY2024 to FY2027.

Excludes2 inherited from the categories above P04.9

Risk adjustment

Alphabetic index entries that lead here

Code history

Other codes under P04