P00 vs P04
P00 (Newborn affected by maternal conditions that may be unrelated to present pregnancy) compared with P04 (Newborn affected by noxious substances transmitted via placenta or breast milk), from the official CMS tabular data. Both may be reported when both conditions are documented (Excludes2).
Can these codes be reported together?
Yes, when both are documented. P00 carries an Excludes2 note covering P04: “newborn affected by noxious substances transmitted via placenta or breast milk (P04.-)”
Excludes2 marks distinct conditions — both may be reported when both are documented.
Side by side
| P00Newborn affected by maternal conditions that may be unrelated to present pregnancy | P04Newborn affected by noxious substances transmitted via placenta or breast milk | |
|---|---|---|
| Billing status | Non-billable header | Non-billable header |
| Classification | P00-P96 — Certain Conditions Originating in the Perinatal Period (P00-P96) | P00-P96 — Certain Conditions Originating in the Perinatal Period (P00-P96) |
| Definition | Newborn affected by maternal conditions that may be unrelated to present pregnancy is a non-billable ICD-10-CM category code (P00). | Newborn affected by noxious substances transmitted via placenta or breast milk is a non-billable ICD-10-CM category code (P04). |
| Includes | — | nonteratogenic effects of substances transmitted via placenta |
| Code first | any current condition in newborn | any current condition in newborn, if applicable |
Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources