P04 vs P58.4
P04 (Newborn affected by noxious substances transmitted via placenta or breast milk) compared with P58.4 (Neonatal jaundice due to drugs or toxins transmitted from mother or given to newborn), 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. P04 carries an Excludes2 note covering P58.4: “neonatal jaundice from excessive hemolysis due to drugs or toxins transmitted from mother (P58.4)”
Excludes2 marks distinct conditions — both may be reported when both are documented.
Side by side
| P04Newborn affected by noxious substances transmitted via placenta or breast milk | P58.4Neonatal jaundice due to drugs or toxins transmitted from mother or given to newborn | |
|---|---|---|
| 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 noxious substances transmitted via placenta or breast milk is a non-billable ICD-10-CM category code (P04). | Neonatal jaundice due to drugs or toxins transmitted from mother or given to newborn is a non-billable ICD-10-CM category code (P58.4). |
| Includes | nonteratogenic effects of substances transmitted via placenta | — |
| Use additional code | — | code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5) |
| Code first | any current condition in newborn, if applicable | poisoning due to drug or toxin, if applicable (T36-T65 with fifth or sixth character 1-4) |
Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources