FY2027 ICD-10-CM reference
P04.1: Newborn affected by other maternal medication
By the HCC Buddy Coding Team
The official ICD-10-CM descriptor is Newborn affected by other maternal medication. The FY2027 annual edition starts October 1, 2026. Check the edition that applies to the encounter or inpatient discharge, including any April update.
Nonbillable heading. Verified against the official FY2027 order file.
More specific FY2027 codes
- P04.11: Newborn affected by maternal antineoplastic chemotherapyBillable code
- P04.12: Newborn affected by maternal cytotoxic drugsBillable code
- P04.13: Newborn affected by maternal use of anticonvulsantsBillable code
- P04.14: Newborn affected by maternal use of opiatesBillable code
- P04.15: Newborn affected by maternal use of antidepressantsBillable code
- P04.16: Newborn affected by maternal use of amphetaminesBillable code
- P04.17: Newborn affected by maternal use of sedative-hypnoticsBillable code
- P04.1A: Newborn affected by maternal use of anxiolyticsBillable code
- P04.18: Newborn affected by other maternal medicationBillable code
- P04.19: Newborn affected by maternal use of unspecified medicationBillable code
FY2027 Tabular instructions
Instructions below include applicable chapter, section and parent-code notes. Each note identifies where it appears in the official source.
Instructional note
Codes from this chapter are for use on newborn records only, never on maternal records
Source: P00-P96 (chapter, inherited).
Includes
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
Source: P00-P96 (chapter, inherited).
Excludes2
congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)
Source: P00-P96 (chapter, inherited).
Excludes2
endocrine, nutritional and metabolic diseases (E00-E88)
Source: P00-P96 (chapter, inherited).
Excludes2
injury, poisoning and certain other consequences of external causes (S00-T88)
Source: P00-P96 (chapter, inherited).
Excludes2
neoplasms (C00-D49)
Source: P00-P96 (chapter, inherited).
Excludes2
tetanus neonatorum (A33)
Source: P00-P96 (chapter, inherited).
Instructional note
These codes are for use when the listed maternal conditions are specified as the cause of confirmed morbidity or potential morbidity which have their origin in the perinatal period (before birth through the first 28 days after birth).
Source: P00-P04 (section, inherited).
Includes
nonteratogenic effects of substances transmitted via placenta
Source: P04 (category, inherited).
Code first
any current condition in newborn, if applicable
Source: P04 (category, inherited).
Excludes2
congenital malformations (Q00-Q99)
Source: P04 (category, inherited).
Excludes2
encounter for observation of newborn for suspected diseases and conditions ruled out (Z05.-)
Source: P04 (category, inherited).
Excludes2
neonatal jaundice from excessive hemolysis due to drugs or toxins transmitted from mother (P58.4)
Source: P04 (category, inherited).
Excludes2
newborn in contact with and (suspected) exposures hazardous to health not transmitted via placenta or breast milk (Z77.-)
Source: P04 (category, inherited).
Code first
, if applicable, withdrawal symptoms from maternal use of drugs of addiction (P96.1)
Source: P04.1 (self, direct).
Code first
withdrawal symptoms from therapeutic use of drugs in newborn (P96.2)
Source: P04.1 (self, direct).
Excludes1
dysmorphism due to warfarin (Q86.2)
Source: P04.1 (self, direct).
Excludes1
fetal hydantoin syndrome (Q86.1)
Source: P04.1 (self, direct).
Excludes2
maternal anesthesia and analgesia in pregnancy, labor and delivery (P04.0)
Source: P04.1 (self, direct).
Excludes2
maternal use of drugs of addiction (P04.4-)
Source: P04.1 (self, direct).
Compare the FY2027 additions, removals and billable-status changes
What does P04.1 mean in FY2027?
The official ICD-10-CM descriptor is Newborn affected by other maternal medication. The FY2027 annual edition starts October 1, 2026. Check the edition that applies to the encounter or inpatient discharge, including any April update.
Is P04.1 billable in FY2027?
The FY2027 order file marks P04.1 as a nonbillable heading. Select a complete billable child code.
Does P04.1 map to an HCC?
Risk-model mapping is not applicable to this nonbillable heading. Check a complete billable child code.
Source: CMS FY2027 ICD-10-CM order file. Read the FY2027 Official Guidelines.
Review the FY2026 April edition