P04.0 vs P04.1
P04.0 (Newborn affected by maternal anesthesia and analgesia in pregnancy, labor and delivery) compared with P04.1 (Newborn affected by other maternal medication), 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. P04.0 carries an Excludes2 note covering P04.1: “newborn affected by other maternal medication (P04.1-)”
Excludes2 marks distinct conditions — both may be reported when both are documented.
Yes, when both are documented. P04.1 carries an Excludes2 note covering P04.0: “maternal anesthesia and analgesia in pregnancy, labor and delivery (P04.0)”
Excludes2 marks distinct conditions — both may be reported when both are documented.
Side by side
| P04.0Newborn affected by maternal anesthesia and analgesia in pregnancy, labor and delivery | P04.1Newborn affected by other maternal medication | |
|---|---|---|
| Billing status | Billable | 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 anesthesia and analgesia in pregnancy, labor and delivery is a billable ICD-10-CM diagnosis code (P04.0). | Newborn affected by other maternal medication is a non-billable ICD-10-CM category code (P04.1). |
| Includes | nonteratogenic effects of substances transmitted via placenta Newborn affected by reactions and intoxications from maternal opiates and tranquilizers administered for procedures during pregnancy or labor and delivery | nonteratogenic effects of substances transmitted via placenta |
| Code first | any current condition in newborn, if applicable | , if applicable, withdrawal symptoms from maternal use of drugs of addiction (P96.1) withdrawal symptoms from therapeutic use of drugs in newborn (P96.2) |
Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources