2024 ICD-10-CM Diagnosis Code P04.3

Newborn affected by maternal use of alcohol

ICD-10-CM Code:
P04.3
ICD-10 Code for:
Newborn affected by maternal use of alcohol
Is Billable?
Yes - Valid for Submission
Chronic Condition Indicator: [1]
Not chronic
Code Navigator:

Code Classification

  • Certain conditions originating in the perinatal period
    (P00–P96)
    • Newborn affected by maternal factors and by complications of pregnancy, labor, and delivery
      (P00-P04)
      • Newborn affected by noxious substances transmitted via placenta or breast milk
        (P04)

P04.3 is a billable diagnosis code used to specify a medical diagnosis of newborn affected by maternal use of alcohol. The code is valid during the current fiscal year for the submission of HIPAA-covered transactions from October 01, 2023 through September 30, 2024.

Approximate Synonyms

The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:

  • Neonatal disorder caused by maternal alcohol transmitted via breast milk
  • Neurodevelopmental disorder due to maternal use of alcohol

Clinical Classification

Clinical CategoryCCSR Category CodeInpatient Default CCSROutpatient Default CCSR
Fetal alcohol syndromePNL015Y - Yes, default inpatient assignment for principal diagnosis or first-listed diagnosis.Y - Yes, default outpatient assignment for principal diagnosis or first-listed diagnosis.
Newborn affected by maternal conditions or complications of labor/deliveryPNL010N - Not default inpatient assignment for principal diagnosis or first-listed diagnosis.N - Not default outpatient assignment for principal diagnosis or first-listed diagnosis.

Tabular List of Diseases and Injuries

The following annotation back-references are applicable to this diagnosis code. The Tabular List of Diseases and Injuries is a list of ICD-10-CM codes, organized "head to toe" into chapters and sections with coding notes and guidance for inclusions, exclusions, descriptions and more.


Type 1 Excludes

Type 1 Excludes
A type 1 excludes note is a pure excludes note. It means "NOT CODED HERE!" An Excludes1 note indicates that the code excluded should never be used at the same time as the code above the Excludes1 note. An Excludes1 is used when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition.
  • fetal alcohol syndrome Q86.0

Index to Diseases and Injuries References

The following annotation back-references for this diagnosis code are found in the injuries and diseases index. The Index to Diseases and Injuries is an alphabetical listing of medical terms, with each term mapped to one or more ICD-10-CM code(s).

Convert P04.3 to ICD-9-CM

  • ICD-9-CM Code: 760.71 - Maternl alc aff NB/fetus
    Approximate Flag - The approximate mapping means there is not an exact match between the ICD-10 and ICD-9 codes and the mapped code is not a precise representation of the original code.

Patient Education


Fetal Alcohol Spectrum Disorders

Alcohol can harm your baby at any stage during a pregnancy. That includes the earliest stages, before you even know you are pregnant. Drinking during pregnancy can cause a group of conditions called fetal alcohol spectrum disorders (FASDs). Children who are born with FASD can have a mix of problems, such as medical, behavioral, educational, and social problems. The kinds of problems they have depend on which type of FASD they have. The problems could include :

  • Abnormal facial features, such as a smooth ridge between the nose and upper lip
  • Small head size
  • Shorter-than-average height
  • Low body weight
  • Poor coordination
  • Hyperactive behavior
  • Difficulty with attention and memory
  • Learning disabilities and difficulty in school
  • Speech and language delays
  • Intellectual disability or low IQ
  • Poor reasoning and judgment skills
  • Sleep and sucking problems as a baby
  • Vision or hearing problems
  • Problems with the heart, kidneys, or bones

Fetal alcohol syndrome (FAS) is the most serious type of FASD. People with fetal alcohol syndrome have facial abnormalities, including wide-set and narrow eyes, growth problems and nervous system abnormalities.

Diagnosing FASD can be hard because there is no medical test, like a blood test, for it. The health care provider will make a diagnosis by looking at the child's signs and symptoms and asking whether the mother drank alcohol during pregnancy.

FASDs last a lifetime. There is no cure for FASDs, but treatments can help. These include medicines to help with some symptoms, medical care for health problems, behavior and education therapy, and parent training. A good treatment plan is specific to the child's problems. It should include close monitoring, follow-ups, and changes when needed.

Certain "protective factors" can help reduce the effects of FASDs and help people who have them reach their full potential. They include:

  • Diagnosis before 6 years of age
  • Loving, nurturing, and stable home environment during the school years
  • Absence of violence around them
  • Involvement in special education and social services

There is no known safe amount of alcohol during pregnancy. To prevent FASDs, you should not drink alcohol while you are pregnant, or when you might get pregnant.

Centers for Disease Control and Prevention


[Learn More in MedlinePlus]

Code History

  • FY 2024 - No Change, effective from 10/1/2023 through 9/30/2024
  • FY 2023 - No Change, effective from 10/1/2022 through 9/30/2023
  • FY 2022 - No Change, effective from 10/1/2021 through 9/30/2022
  • FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
  • FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
  • FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
  • FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
  • FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
  • FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016. This was the first year ICD-10-CM was implemented into the HIPAA code set.

Footnotes

[1] Not chronic - A diagnosis code that does not fit the criteria for chronic condition (duration, ongoing medical treatment, and limitations) is considered not chronic. Some codes designated as not chronic are acute conditions. Other diagnosis codes that indicate a possible chronic condition, but for which the duration of the illness is not specified in the code description (i.e., we do not know the condition has lasted 12 months or longer) also are considered not chronic.