2027 ICD-10-CM Diagnosis Code P35.4Congenital Zika virus disease

ICD-10-CM Codes›P00–P96›P35-P39›P35

ICD-10-CM P35.4
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

P35.4 is a billable ICD-10-CM diagnosis code for congenital Zika virus disease. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 791, 793. As a secondary diagnosis, it counts as a major complication or comorbidity (MCC) and places an inpatient stay in the highest severity level of its MS-DRG family. It does not count, however, when the principal diagnosis is one of 190 closely related codes. Coders also document this condition as congenital infection caused by Zika virus. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Perinatal infections and Viral infection.

Code Identity

ICD-10-CM Code
P35.4
Billable Status
Yes — Valid for Submission
Code Describes
Congenital Zika virus disease
Short Description
Congenital Zika virus disease
Same as the full description in the CMS dataset.
Parent Code
P35
Congenital viral diseases

Code Classification

ChapterP00–P96Certain conditions originating in the perinatal period
SectionP35-P39Infections specific to the perinatal period
CategoryP35Congenital viral diseases
This CodeP35.4Congenital Zika virus disease

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Congenital infection caused by Zika virus
  • Zika virus disease

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to P35.4: its own notes plus those printed at P35, block P35-P39, 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.

From P35 Congenital viral diseases applies to 7 codes
  • infections acquired in utero or during birth
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.

From Block P35-P39 Infections specific to the perinatal period applies to 34 codes
  • asymptomatic human immunodeficiency virus [HIV] infection status (Z21)
  • congenital gonococcal infection (A54.-)
  • congenital pneumonia (P23.-)
  • congenital syphilis (A50.-)
  • human immunodeficiency virus [HIV] disease (B20)
  • infant botulism (A48.51)
  • infectious diseases not specific to the perinatal period (A00-B99, J09, J10.-)
  • intestinal infectious disease (A00-A09)
  • laboratory evidence of human immunodeficiency virus [HIV] (R75)
  • tetanus neonatorum (A33)
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)

Use Additional Code

Add a second code, after this one, to fully describe the condition.

  • code to identify manifestations of congenital Zika virus disease

Notes

General instructions on how these codes are used.

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 P35.4, its category, or a range that includes it.

Excludes1 1

These codes carry an Excludes1 note naming P35.4: they are not reported together with it, unless the two conditions are unrelated.

  • A92.5 Zika virus disease
    congenital Zika virus disease (P35.4)

Excludes2 2

These codes carry an Excludes2 note naming P35.4: its condition is not part of those codes, and both may be reported when the patient has both.

  • Chapter 1 (A00-B99) Certain infectious and parasitic diseases
    infectious and parasitic diseases specific to the perinatal period (P35-P39) names P35-P39, which includes this code
  • P00.2 Newborn affected by maternal infectious and parasitic diseases
    infections specific to the perinatal period (P35-P39) names P35-P39, which includes this code

Index to Diseases and InjuriesGuidance

Alphabetical index entries that point to this code.

Clinical ClassificationClinical

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

CCSR PNL009
Perinatal infections
Default principal diagnosis: inpatient Yes · outpatient Yes
CCSR INF008
Viral infection
Default principal diagnosis: inpatient No · outpatient No

Patient EducationClinical

Uncommon Infant and Newborn Problems

It can be scary when your baby is sick, especially when it is not an everyday problem like a cold or a fever. You may not know whether the problem is serious or how to treat it. If you have concerns about your baby's health, call your health care provider right away.

Read the full article at MedlinePlus

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

Code History & ChangesHistory

Replacement P35.4 replaces the following previously assigned code(s):

  • A92.5 - Zika virus disease
  • P35.8 - Other congenital viral diseases
FY 2019AddedAdded to the ICD-10-CM code setEffective October 1, 2018.
FY 2020–2026No changes
FY 2027CurrentCurrent code set, no changesEffective October 1, 2026 through September 30, 2027.

Questions About P35.4Overview

What is the ICD-10 code for congenital Zika virus disease?

The ICD-10-CM code for congenital Zika virus disease is P35.4 (sometimes written as P354). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

Is P35.4 (Congenital viral diseases) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report congenital Zika virus disease on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

What MS-DRG does P35.4 group to?

When congenital Zika virus disease is the principal diagnosis on an inpatient stay, it groups to MS-DRG 793, 791, with relative weights from 4.1073 to 4.2192 depending on complications. Higher weights mean higher Medicare reimbursement.

Is P35.4 a CC or MCC?

CMS lists P35.4 as an MCC (major complication or comorbidity) for FY 2027. Reported as a secondary diagnosis, it places the inpatient stay in the highest-weighted DRG of its severity family. It does not count when the principal diagnosis is one of the 190 closely related codes in its exclusion list.

Does P35.4 need an additional code?

When the condition applies, yes. The Use Additional Code note reads: code to identify manifestations of congenital Zika virus disease. The additional code is reported after P35.4.