P04.3 vs Q86.0
P04.3 (Newborn affected by maternal use of alcohol) compared with Q86.0 (Fetal alcohol syndrome (dysmorphic)), from the official CMS tabular data. Do not report these codes together: the official tabular list marks them Excludes1.
Can these codes be reported together?
No — do not report together. P04.3 carries an Excludes1 note covering Q86.0: “fetal alcohol syndrome (Q86.0)”
Sole exception: when the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).
Yes, when both are documented. Q86.0 carries an Excludes2 note covering P04.3: “nonteratogenic effects of substances transmitted via placenta or breast milk (P04.-)”
Excludes2 marks distinct conditions — both may be reported when both are documented.
Side by side
| P04.3Newborn affected by maternal use of alcohol | Q86.0Fetal alcohol syndrome (dysmorphic) | |
|---|---|---|
| Billing status | Billable | Billable |
| Classification | P00-P96 — Certain Conditions Originating in the Perinatal Period (P00-P96) | Q00-Q99 — Congenital Malformations, Deformations and Chromosomal Abnormalities (Q00-Q99) |
| Definition | Newborn affected by maternal use of alcohol is a billable ICD-10-CM diagnosis code (P04.3). | Fetal alcohol syndrome (dysmorphic) is a billable ICD-10-CM diagnosis code (Q86.0). |
| Includes | nonteratogenic effects of substances transmitted via placenta | — |
| Code first | 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