2026 ICD-10-CM Diagnosis Code P04.42Newborn affected by maternal use of hallucinogens
ICD-10-CM Codes›P00–P96›P00-P04›P04
- Billable — Valid for Submission
- Chronic Condition
P04.42 is a billable ICD-10-CM diagnosis code for newborn affected by maternal use of hallucinogens. 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 hallucinogenic agent transmitted via breast milk. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Neonatal abstinence syndrome and Newborn affected by maternal conditions or complications of labor/delivery.
Code Identity
Code Classification
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Neonatal disorder caused by hallucinogenic agent transmitted via breast milk
Tabular List NotesGuidance
Coding notes and annotation back-references applicable to this code.
Type 2 Excludes
- newborn affected by other maternal medication P04.1
A type 2 excludes note represents "Not included here". An excludes2 note indicates that the condition excluded is not part of the condition represented by the code, but a patient may have both conditions at the same time. When an Excludes2 note appears under a code, it is acceptable to use both the code and the excluded code together, when appropriate.
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
- drug NEC - See: Table of Drugs and Chemicals;
- through placenta (newborn) - See Also: Newborn, affected by, maternal, use of; - P04.40
- hallucinogens - P04.42
- Newborn (infant) (liveborn) (singleton) - Z38.2
- hallucinogens - P04.42
External Cause of Injuries IndexGuidance
References for this code in the External Cause of Injuries Index.
- Absorption
- drug NEC
- addictive
- through placenta (newborn)
- hallucinogens
- Newborn(infant) (liveborn) (singleton)
- affected by
- drugs of addiction
- hallucinogens
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Patient EducationClinical
Club Drugs
Club drugs are a group of psychoactive drugs. They act on the central nervous system and can cause changes in mood, awareness, and behavior. These drugs are most often used by young adults at bars, concerts, nightclubs, and parties.
The full article covers:
- What are club drugs?
- What are the different types of club drugs?
- What are date rape drugs?
- Are there steps I can take to protect myself from date rape drugs?
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Code History & ChangesHistory
Replacement P04.42 replaces the following previously assigned code(s):
- P04.49 - Newborn affected by maternal use of drugs of addiction
- P04.49 - Newborn affected by maternal use of other drugs of addiction
Questions About P04.42Overview
Is P04.42 (Newborn affected by maternal use of drugs of addiction) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report newborn affected by maternal use of hallucinogens on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
Footnotes
[1] Chronic - a chronic condition code indicates a condition lasting 12 months or longer and its effect on the patient based on one or both of the following criteria:
- The condition results in the need for ongoing intervention with medical products,treatment, services, and special equipment
- The condition places limitations on self-care, independent living, and social interactions.
