2026 ICD-10-CM Diagnosis Code P04.3Newborn affected by maternal use of alcohol

ICD-10-CM Codes›P00–P96›P00-P04›P04

ICD-10-CM P04.3
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

P04.3 is a billable ICD-10-CM diagnosis code for newborn affected by maternal use of alcohol. 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 maternal alcohol transmitted via breast milk. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Fetal alcohol syndrome and Newborn affected by maternal conditions or complications of labor/delivery.

Code Identity

ICD-10-CM Code
P04.3
Billable Status
Yes — Valid for Submission
Code Describes
Newborn affected by maternal use of alcohol
Short Description
Newborn affected by maternal use of alcohol
Same as the full description in the CMS dataset.
Parent Code
P04
Newborn affected by noxious substances transmitted via placenta or breast milk

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 CodeP04.3Newborn affected by maternal use of alcohol

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

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

Tabular List NotesGuidance

Coding notes and annotation back-references applicable to this code.

Type 1 Excludes

  • fetal alcohol syndrome Q86.0

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
        • maternal (complication of) (use of)
          • alcohol

Clinical ClassificationClinical

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

CCSR PNL015
Fetal alcohol syndrome
Default principal diagnosis: inpatient Yes · outpatient Yes
CCSR PNL010
Newborn affected by maternal conditions or complications of labor/delivery
Default principal diagnosis: inpatient No · outpatient No

Patient EducationClinical

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).

Read the full article at MedlinePlus

Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.

Convert P04.3 to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
760.71 Maternl alc aff NB/fetus
Approximate The match is approximate rather than exact.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2025No changes
FY 2026CurrentCurrent code set, no changesEffective October 1, 2025 through September 30, 2026.

Questions About P04.3Overview

Is P04.3 a billable code?

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

What is the ICD-9 equivalent of P04.3?

Under the General Equivalence Mappings, newborn affected by maternal use of alcohol converts to ICD-9-CM 760.71 (maternl alc aff NB/fetus). The mapping is approximate, so confirm the match fits the documentation.

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.