P00.4 ICD-10-CM Code: Newborn affected by maternal nutritional disorders

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for P00.4 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2026Effective: October 1, 2025

Notes without a marker are published on P00.4 itself; “inherited from” names the category or block whose note applies here.

Coder workflow for P00.4

MedCoder structured workflow — derived from this code’s own official record

Choose the right path

1. Is the underlying (etiologic) condition the Code First note names documented?
   Yes → Sequence the underlying condition first, then P00.4.
   No → Continue; do not add an underlying condition the record does not document.

Consider P00.4. Then confirm the code is valid for the date of service in the Verify section.

Documentation check

The provider’s diagnostic statement

Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).

The underlying (etiologic) condition

Named in the Code First note; sequenced before this code when documented (Guidelines I.A.13).

Official instructions as workflow

• Excludes2 — not part of P00.4(4 notes)

  Coding workflow: The conditions named in this note are not included in P00.4. When the record documents both, both may be reported; the note is a boundary, not a prohibition.

  CompareZ05, P01, P04

  See the official tabular notes · Guidelines I.A.12.b

• Code First — sequencing check(1 note)

  Coding workflow: Check whether the underlying or etiologic condition the note names is documented. When it is, sequence it before P00.4. Do not add an underlying condition the record does not document.

  See the official tabular notes · Guidelines I.A.13

Coding decision scenarios

Pattern scenarios for this code’s structure — decision rules, not clinical cases

Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.

Indexed Clinical Terms (1)

Official source data — entries quoted as published, in the Index’s own lookup phrasing

Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code. These are alphabetic-index entries shown as the Index writes them — lookup phrasing, not necessarily the wording of a final diagnosis.

• Newborn (infant) (liveborn) (singleton), affected by, maternal (complication of) (use of), nutritional disorder

Don’t confuse P00.4 with…

MedCoder analysis — pairs from this code’s official notes, distinctions written by MedCoder

The codes most likely to be picked instead of P00.4 — named in its own official notes, or sharing its laterality or encounter family — with what separates them and which documentation moves the case. Each links to the full comparison.

• P00.9— Specificity relationship (Review)

  Overlapping diagnoses in the same category.

  Overlapping codes in the same category — the documentation decides which is the more specific fit.

  What moves you there: A record that documents no more than “Newborn affected by unspecified maternal condition” takes P00.9; specificity in the record moves it back here.

  Full comparison: P00.4 vs P00.9 →

• Z05— Excludes2 relationship (Informational)

  Distinct conditions — both may be reported.

  A distinct condition — both may be reported when both are documented.

  What moves you there: Documentation of encounter for observation of newborn for suspected diseases and conditions ruled out adds Z05; it is not part of this code and both may be reported when both are documented.

  Full comparison: P00.4 vs Z05 →

• P01— Excludes2 relationship (Informational)

  Distinct conditions — both may be reported.

  A distinct condition — both may be reported when both are documented.

  What moves you there: Documentation of newborn affected by maternal complications of pregnancy adds P01; it is not part of this code and both may be reported when both are documented.

  Full comparison: P00.4 vs P01 →

• P70— Excludes2 relationship (Informational)

  Distinct conditions — both may be reported.

  A distinct condition — both may be reported when both are documented.

  What moves you there: Documentation of newborn affected by maternal endocrine and metabolic disorders adds P70; it is not part of this code and both may be reported when both are documented.

  Full comparison: P00.4 vs P70 →

• P74— Excludes2 relationship (Informational)

  Distinct conditions — both may be reported.

  A distinct condition — both may be reported when both are documented.

  What moves you there: Documentation of newborn affected by maternal endocrine and metabolic disorders adds P74; it is not part of this code and both may be reported when both are documented.

  Full comparison: P00.4 vs P74 →

• P04— Excludes2 relationship (Informational)

  Distinct conditions — both may be reported.

  A distinct condition — both may be reported when both are documented.

  What moves you there: Documentation of newborn affected by noxious substances transmitted via placenta or breast milk adds P04; it is not part of this code and both may be reported when both are documented.

  Full comparison: P00.4 vs P04 →

Relationships are read from this code's own official notes, its laterality siblings and its encounter family; the wording of each distinction is MedCoder editorial, and the documentation named in each “what moves you there” line is the official note phrase or sibling title itself. Source: CMS ICD-10-CM tabular instructional notes; ICD-10-CM Official Guidelines, Section I.A.12.a.

Verify Before Coding

• No Medicare Code Editor or MS-DRG Definitions Manual restrictions apply to this code.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.

Relationships & Classification

MedCoder structured relationships — computed from published CMS and AHRQ datasets

MS-DRG Grouper Relationships (FY2026)

Potential MS-DRG participation — not a DRG assignment.

FY2026 MS-DRG: not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity for that release.

Named in the grouper logic of 1 MS-DRG: DRG 794 (MDC 15).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Clinical classification (AHRQ CCSR):PNL010 — Newborn affected by maternal conditions or complications of labor/delivery (default).

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Related Codes

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Newborn affected by maternal conditions or complications of labor/delivery).

P00.0 — Newborn affected by maternal hypertensive disorders, P00.1 — Newborn affected by maternal renal and urinary tract diseases, P00.2 — Newborn affected by maternal infectious and parasitic diseases, P00.3 — Newborn affected by other maternal circulatory and respiratory diseases, P00.5 — Newborn affected by maternal injury, P00.6 — Newborn affected by surgical procedure on mother, P00.7 — Newborn affected by other medical procedures on mother, not elsewhere classified, P00.81 — Newborn affected by periodontal disease in mother, P00.82 — Newborn affected by (positive) maternal group B streptococcus (GBS) colonization, P00.89 — Newborn affected by other maternal conditions, P00.9 — Newborn affected by unspecified maternal condition, P01.0 — Newborn affected by incompetent cervix, P01.1 — Newborn affected by premature rupture of membranes, P01.2 — Newborn affected by oligohydramnios, P01.3 — Newborn affected by polyhydramnios, P01.4 — Newborn affected by ectopic pregnancy, P01.5 — Newborn affected by multiple pregnancy, P01.6 — Newborn affected by maternal death, P01.7 — Newborn affected by malpresentation before labor, P01.8 — Newborn affected by other maternal complications of pregnancy, +53 more

Same Index main term, other category

The ICD-10-CM Index to Diseases and Injuries files this code under the main term “Newborn”; these codes share that main term but sit in a different category of the Tabular List.

I42.4 — Endocardial fibroelastosis (affected by, cardiomyopathy, congenital), I42.89 — Other cardiomyopathies not elsewhere classified (affected by, cardiomyopathy), L70.4 — Infantile acne (acne), P01.0 — Newborn affected by incompetent cervix (affected by, maternal, incompetent cervix), P01.1 — Newborn affected by premature rupture of membranes (affected by, maternal, premature rupture of membranes), P01.2 — Newborn affected by oligohydramnios (affected by, maternal, oligohydramnios), P01.3 — Newborn affected by polyhydramnios (affected by, maternal, polyhydramnios), P01.4 — Newborn affected by ectopic pregnancy (affected by, maternal, ectopic pregnancy), P01.5 — Newborn affected by multiple pregnancy (affected by, maternal, multiple pregnancy), P01.6 — Newborn affected by maternal death (affected by, maternal, maternal death), P01.7 — Newborn affected by malpresentation before labor (affected by, maternal, malpresentation before labor), P01.8 — Newborn affected by other maternal complications of pregnancy (affected by, maternal, pregnancy, specified), P01.9 — Newborn affected by maternal complication of pregnancy, unspecified (affected by, maternal, pregnancy), P02.0 — Newborn affected by placenta previa (affected by, placenta previa), P02.1 — Newborn affected by other forms of placental separation and hemorrhage (affected by, hemorrhage), P02.20 — Newborn affected by unspecified morphological and functional abnormalities of placenta (affected by, placental, abnormality), P02.29 — Newborn affected by other morphological and functional abnormalities of placenta (affected by, placental, infarction), P02.3 — Newborn affected by placental transfusion syndromes (affected by, placental, transfusion syndromes), P02.4 — Newborn affected by prolapsed cord (affected by, prolapsed cord), P02.5 — Newborn affected by other compression of umbilical cord (affected by, umbilical cordaround neck), +137 more

Contextual Map

Every relationship of P00.4 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Hierarchy

• P00-P96 — Chapter 16: Certain Conditions Originating in the Perinatal Period (P00-P96) (P00-P96)[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• P00-P04 — Newborn affected by maternal factors and by complications of pregnancy, labor, and delivery[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026

Clinical classification (CCSR)

• PNL010 — Newborn affected by maternal conditions or complications of labor/delivery[CCSR]— AHRQ CCSR for ICD-10-CM Diagnoses (HCUP)

MS-DRG Grouper

• DRG 794 — NEONATE WITH OTHER SIGNIFICANT PROBLEMS[MS-DRG]: “NEONATE WITH OTHER SIGNIFICANT PROBLEMS (MDC 15)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026

MDC crossing

• MDC 15 — Newborns and Other Neonates with Conditions Originating in Perinatal Period[MDC crossing]: “Newborns and Other Neonates with Conditions Originating in Perinatal Period — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs.”— CMS MS-DRG Definitions Manual · FY2026

Index entries

• Newborn (infant) (liveborn) (singleton), affected by, maternal (complication of) (use of), nutritional disorder[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026

Nearest codes (13)

• P00 — Newborn affected by maternal conditions that may be unrelated to present pregnancy[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• P00.0 — Newborn affected by maternal hypertensive disorders[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• P00.1 — Newborn affected by maternal renal and urinary tract diseases[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• P00.2 — Newborn affected by maternal infectious and parasitic diseases[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• P00.3 — Newborn affected by other maternal circulatory and respiratory diseases[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• P00.5 — Newborn affected by maternal injury[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• P00.6 — Newborn affected by surgical procedure on mother[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• P00.7 — Newborn affected by other medical procedures on mother, not elsewhere classified[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• and 5 more

Change history (2)

• FY2017 — Description revised[Change history]— CMS release files (code change ledger) · icd10cm-fy2017
• and 1 more

Sources for this page

Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.

Code, title, tabular notes and index terms Official source data

CMS/CDC ICD-10-CM FY2026 tabular list, index and tables, effective October 1, 2025 Release, file and checksum · Publisher’s page

Claim edits Official source data

CMS Definitions of Medicare Code Edits — v43.1 (April 2026) Release, file and checksum · Publisher’s page

Inpatient payment groups Official source data

CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v43 Release, file and checksum · Publisher’s page

Change history and date-of-service validity Official source data

CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page

Comparisons, relationships and the contextual map MedCoder structured relationship

Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears

Summary and FAQ answers MedCoder explanation

Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.

Labels on this page: Official source data · MedCoder structured relationship · MedCoder explanation. How to read the labels · All data sources and release dates

Nearest Codes in This Family

Official ICD-10-CM classifications closest to P00.4 in its code family, with their registry titles.

• P00 — Newborn affected by maternal conditions that may be unrelated to present pregnancy
• P00.0 — Newborn affected by maternal hypertensive disorders
• P00.1 — Newborn affected by maternal renal and urinary tract diseases
• P00.2 — Newborn affected by maternal infectious and parasitic diseases
• P00.3 — Newborn affected by other maternal circulatory and respiratory diseases
• P00.5 — Newborn affected by maternal injury
• P00.6 — Newborn affected by surgical procedure on mother
• P00.7 — Newborn affected by other medical procedures on mother, not elsewhere classified
• P00.8 — Newborn affected by other maternal conditions
• P00.81 — Newborn affected by periodontal disease in mother

View all codes in the P00 family