2026 ICD-10-CM Diagnosis Code P04.49Newborn affected by maternal use of other drugs of addiction

ICD-10-CM CodesP00–P96P00-P04P04

ICD-10-CM P04.49
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

P04.49 is a billable ICD-10-CM diagnosis code for newborn affected by maternal use of other drugs of addiction. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026). 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

ICD-10-CM Code
P04.49
Billable Status
Yes — Valid for Submission
Code Describes
Newborn affected by maternal use of other drugs of addiction
Short Description
Newborn affected by maternal use of other drugs of addiction
Same as the full description in the CMS dataset.
Parent Code
Newborn affected by maternal use of drugs of addiction

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 CodeP04.49Newborn affected by maternal use of other drugs of addiction

Tabular List NotesGuidance

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

Type 2 Excludes

  • newborn affected by maternal anesthesia and analgesia P04.0
  • withdrawal symptoms from maternal use of drugs of addiction P96.1

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.

    • Absorption
      • drug NEC
        • addictive
          • through placenta (newborn)
            • specified drug NEC
    • Newborn(infant) (liveborn) (singleton)
      • affected by
        • drugs of addiction
          • specified drug NEC
    • Newborn(infant) (liveborn) (singleton)
      • affected by
        • maternal (complication of) (use of)
          • drugs (addictive) (illegal) NEC
    • Newborn(infant) (liveborn) (singleton)
      • affected by
        • methamphetamine (s)

Clinical ClassificationClinical

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

CCSR PNL014
Neonatal abstinence 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

Pregnancy and Substance Use

During pregnancy, there are many things you can do to keep yourself and your baby healthy. They include getting regular prenatal care, eating healthy, and staying active. But it's also very important to avoid substances that could be harmful to you and your baby, such as tobacco, alcohol, and drugs.

Read the full article at MedlinePlus

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

Convert P04.49 to ICD-9-CMHistory

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

ICD-9-CM
760.72 Matern narc aff NB/fetus
Approximate The match is approximate rather than exact.
ICD-9-CM
760.73 Matern halluc af NB/fet
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 P04.49Overview

Is P04.49 (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 other drugs of addiction on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

What is the ICD-9 equivalent of P04.49?

Under the General Equivalence Mappings, newborn affected by maternal use of other drugs of addiction converts to ICD-9-CM 760.72 (matern narc aff NB/fetus) and 760.73 (matern halluc af NB/fet). The mapping is approximate, so confirm the match fits the documentation.

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.