2027 ICD-10-CM Diagnosis Code P04Newborn affected by noxious substances transmitted via placenta or breast milk

ICD-10-CM Codes›P00–P96›P00-P04›P04

ICD-10-CM P04
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

P04 is a non-billable ICD-10-CM category code for newborn affected by noxious substances transmitted via placenta or breast milk, so it cannot be submitted on claims. Use a more specific code from this category instead, such as P04.0, P04.11, P04.12, and P04.13.

Code Identity

ICD-10-CM Code
P04
Billable Status
No — Non-Billable Category
Code Describes
Newborn affected by noxious substances transmitted via placenta or breast milk
Short Description
NB aff by noxious substnc transmitd via plcnta or brst milk
Chapter
P00-P04
Newborn affected by maternal factors and by complications of pregnancy, labor, and delivery

Code Classification

ChapterP00–P96Certain conditions originating in the perinatal period
SectionP00-P04Newborn affected by maternal factors and by complications of pregnancy, labor, and delivery
CategoryP04Newborn affected by noxious substances transmitted via placenta or breast milk
This CodeP04Newborn affected by noxious substances transmitted via placenta or breast milk

Specific Coding for NB aff by noxious substnc transmitd via plcnta or brst milkOverview

Non-specific codes like P04 require more characters. Use one of these billable codes instead:

  • Use P04.0 for Newborn affected by maternal anesthesia and analgesia in pregnancy, labor and delivery

  • P04.1 for Newborn affected by other maternal medication

  • Use P04.11 for Newborn affected by maternal antineoplastic chemotherapy

  • Use P04.12 for Newborn affected by maternal cytotoxic drugs

  • Use P04.13 for Newborn affected by maternal use of anticonvulsants

  • Use P04.14 for Newborn affected by maternal use of opiates

  • Use P04.15 for Newborn affected by maternal use of antidepressants

  • Use P04.16 for Newborn affected by maternal use of amphetamines

  • Use P04.17 for Newborn affected by maternal use of sedative-hypnotics

  • Use P04.18 for Newborn affected by other maternal medication

  • Use P04.19 for Newborn affected by maternal use of unspecified medication

  • Use P04.1A for Newborn affected by maternal use of anxiolytics

  • Use P04.2 for Newborn affected by maternal use of tobacco

  • Use P04.3 for Newborn affected by maternal use of alcohol

  • P04.4 for Newborn affected by maternal use of drugs of addiction

  • Use P04.40 for Newborn affected by maternal use of unspecified drugs of addiction

  • Use P04.41 for Newborn affected by maternal use of cocaine

  • Use P04.42 for Newborn affected by maternal use of hallucinogens

  • Use P04.49 for Newborn affected by maternal use of other drugs of addiction

  • Use P04.5 for Newborn affected by maternal use of nutritional chemical substances

  • Use P04.6 for Newborn affected by maternal exposure to environmental chemical substances

  • P04.8 for Newborn affected by other maternal noxious substances

  • Use P04.81 for Newborn affected by maternal use of cannabis

  • Use P04.89 for Newborn affected by other maternal noxious substances

  • Use P04.9 for Newborn affected by maternal noxious substance, unspecified

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to P04: its own notes plus those printed at block P00-P04 and Chapter 16. A note printed at a category, block or chapter applies to every code under it.

Includes

Further defines, or gives examples of, the content of the category.

On P04 itself
  • nonteratogenic effects of substances transmitted via placenta
From Chapter 16 (P00-P96) Certain conditions originating in the perinatal period applies to 463 codes
  • conditions that have their origin in the fetal or perinatal period (before birth through the first 28 days after birth) even if morbidity occurs later

Excludes2

Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.

On P04 itself
  • 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.-)
From Chapter 16 (P00-P96) Certain conditions originating in the perinatal period applies to 463 codes
  • congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)
  • endocrine, nutritional and metabolic diseases (E00-E88)
  • injury, poisoning and certain other consequences of external causes (S00-T88)
  • neoplasms (C00-D49)
  • tetanus neonatorum (A33)

Code First

The underlying condition named in the note is sequenced before this code.

  • any current condition in newborn, if applicable

Notes

General instructions on how these codes are used.

From Block P00-P04 Newborn affected by maternal factors and by complications of pregnancy, labor, and delivery applies to 70 codes
  • These codes are for use when the listed maternal conditions are specified as the cause of confirmed morbidity or potential morbidity which have their origin in the perinatal period (before birth through the first 28 days after birth).
From Chapter 16 (P00-P96) Certain conditions originating in the perinatal period applies to 463 codes
  • Codes from this chapter are for use on newborn records only, never on maternal records

Source: CMS ICD-10-CM Tabular List. How to read instructional notes.

Referenced in Other NotesGuidance

Instructional notes printed at other codes that name P04, its category, or a range that includes it.

Excludes2 3

These codes carry an Excludes2 note naming P04: its condition is not part of those codes, and both may be reported when the patient has both.

  • P00 Newborn affected by maternal conditions that may be unrelated to present pregnancy
    newborn affected by noxious substances transmitted via placenta or breast milk (P04.-)
  • Q86 Congenital malformation syndromes due to known exogenous causes, not elsewhere classified
    nonteratogenic effects of substances transmitted via placenta or breast milk (P04.-)
  • Z77 Other contact with and (suspected) exposures hazardous to health
    newborn affected by noxious substances transmitted via placenta or breast milk (P04.-)

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2026No changes
FY 2027CurrentCurrent code set, no changesEffective October 1, 2026 through September 30, 2027.

Questions About P04Overview

Is P04 a billable code?

No. This is a category header that groups the codes for newborn affected by noxious substances transmitted via placenta or breast milk, and headers cannot be submitted on claims. Claims for newborn affected by noxious substances transmitted via placenta or breast milk need a more specific code from this category, such as P04.0, P04.11, and P04.12.

What is coded first with P04?

The Code First note reads: any current condition in newborn, if applicable. When one of these applies, it is sequenced before P04.