2026 ICD-10-CM Diagnosis Code P04.11Newborn affected by maternal antineoplastic chemotherapy

ICD-10-CM Codes›P00–P96›P00-P04›P04

ICD-10-CM P04.11
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

P04.11 is a billable ICD-10-CM diagnosis code for newborn affected by maternal antineoplastic chemotherapy. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026). Coders also document this condition as neonatal disorder caused by antineoplastic agent transmitted via breast milk. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Newborn affected by maternal conditions or complications of labor/delivery.

Code Identity

ICD-10-CM Code
P04.11
Billable Status
Yes — Valid for Submission
Code Describes
Newborn affected by maternal antineoplastic chemotherapy
Short Description
Newborn affected by maternal antineoplastic chemotherapy
Same as the full description in the CMS dataset.
Parent Code
P04.1
Newborn affected by other maternal medication

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 CodeP04.11Newborn affected by maternal antineoplastic chemotherapy

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Neonatal disorder caused by antineoplastic agent transmitted via breast milk

Index to Diseases and InjuriesGuidance

Alphabetical index entries that point to this code.

External Cause of Injuries IndexGuidance

References for this code in the External Cause of Injuries Index.

    • Newborn(infant) (liveborn) (singleton)
      • affected by
        • chemotherapy agents
    • Newborn(infant) (liveborn) (singleton)
      • affected by
        • maternal (complication of) (use of)
          • antineoplastic chemotherapy

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR PNL010
Newborn affected by maternal conditions or complications of labor/delivery
Default principal diagnosis: inpatient Yes · outpatient Yes

Code History & ChangesHistory

Replacement P04.11 replaces the following previously assigned code(s):

  • P04.1 - Newborn affected by oth maternal medication
  • P04.1 - Newborn affected by other maternal medication
FY 2019AddedAdded to the ICD-10-CM code setEffective October 1, 2018.
FY 2020–2025No changes
FY 2026CurrentCurrent code set, no changesEffective October 1, 2025 through September 30, 2026.

Questions About P04.11Overview

Is P04.11 (Newborn affected by other maternal medication) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report newborn affected by maternal antineoplastic chemotherapy on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

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.