P04.1 vs P04.4
P04.1 (Newborn affected by other maternal medication) compared with P04.4 (Newborn affected by maternal use of drugs of addiction), 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. P04.1 carries an Excludes2 note covering P04.4: “maternal use of drugs of addiction (P04.4-)”
Excludes2 marks distinct conditions — both may be reported when both are documented.
Side by side
| P04.1Newborn affected by other maternal medication | P04.4Newborn affected by maternal use of drugs of addiction | |
|---|---|---|
| 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 other maternal medication is a non-billable ICD-10-CM category code (P04.1). | Newborn affected by maternal use of drugs of addiction is a non-billable ICD-10-CM category code (P04.4). |
| Includes | nonteratogenic effects of substances transmitted via placenta | nonteratogenic effects of substances transmitted via placenta |
| Code first | , if applicable, withdrawal symptoms from maternal use of drugs of addiction (P96.1) withdrawal symptoms from therapeutic use of drugs in newborn (P96.2) | 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