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P58.4 ICD-10-CM Code: Neonatal jaundice due to drugs or toxins transmitted from mother or given to newborn

Billing Status: NO. This is a clinician non-billable / parent hierarchy grouping in the ICD-10-CM system.

Coding at a Glance

Tabular directives
6 Excludes1 · 1 use-additional code · 1 code-first instruction

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for P58.4 in the official ICD-10-CM tabular list, quoted as published.

Notes without a marker are published on P58.4 itself; “inherited from” names the category or block whose note applies here.

Excludes1 — Not Coded Here

Conditions generally not reported together with this code (Excludes1) -- an error unless the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Code First

Underlying conditions that must be sequenced before this code.

  • poisoning due to drug or toxin, if applicable (T36-T65 with fifth or sixth character 1-4)

Use Additional Code

Supplementary codes the tabular list directs you to add.

  • Use additional code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5)

Coder workflow for P58.4

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

Before you code P58.4

  1. P58.4 is not reportable as written. Select the more specific code beneath it that the documentation supports. Codes are reported to the highest level of specificity the classification provides (Guidelines I.B.2).

    ReviewP58.41, P58.42

    See the relationships section · Guide: How to choose an ICD-10-CM code →

  2. P58.4’s title joins a condition with an associated condition or complication. Confirm each component is documented. Where the classification presumes the link through the “with” convention, only a provider statement that the conditions are unrelated defeats it. A combination code is assigned only when it fully identifies the documented conditions; a required second code for the stage, type or manifestation is still reported when the notes ask for it (Guidelines I.B.9, I.A.15).

    Guide: Combination codes →

  3. Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with P58.4. Excludes1 conditions are not reported together with this code unless the record shows they are unrelated (Guidelines I.A.12.a).

    See the official tabular notes

Choose the right path

  1. Does the documentation support one of the more specific codes beneath P58.4?
    Yes → Select that code and continue the checks below on its own page.
    No → P58.4 cannot be reported as written; query for the specificity its subcategory needs.

    ReviewP58.41, P58.42

  2. Does the documentation support a condition named in P58.4’s Excludes1 note?
    Yes → Do not simply proceed: review the excluded code. Both are reported only when the record shows the two conditions are unrelated.
    No → Continue.

    ReviewQ44.3, E80.5, E80.6, E80.4

  3. Is the underlying (etiologic) condition the Code First note names documented?
    Yes → Sequence the underlying condition first, then P58.4.
    No → Continue; do not add an underlying condition the record does not document.

Consider P58.4. Then work the Use Additional Code note, and 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 associated condition or complication
Whether the associated condition the title names is documented; the “with” convention presumes some links, and a provider statement that the conditions are unrelated defeats it (Guidelines I.A.15).
The underlying (etiologic) condition
Named in the Code First note; sequenced before this code when documented (Guidelines I.A.13).
The conditions the Use Additional Code note names
Reported with this code when documented; a conditional instruction (“if applicable”, “if known”) applies only when the record supports it.

Official instructions as workflow

  • Excludes1 — check before selecting P58.4(6 notes)

    Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with P58.4: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.

    CompareQ44.3, E80.5, E80.6, E80.4

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

  • 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 P58.4. Do not add an underlying condition the record does not document.

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

  • Use Additional Code — after identifying P58.4(1 note)

    Coding workflow: Check whether the documentation supports the additional code(s) the note names, and report them with P58.4 when it does. Where the instruction is conditional (“if applicable”, “if known”), it applies only when the record documents the condition.

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

Coding decision scenarios

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

Documentation: Both the condition P58.4 describes and a condition named in its Excludes1 note are documented for the same encounter.

Coding question: Can both codes be reported?

Path: Review the Excludes1 note and the excluded code, and look for a provider statement on whether the two conditions are related.

Reason: Excludes1 means the two are not coded together; the exception is when the record shows the conditions are unrelated to each other (Guidelines I.A.12.a).

ReviewQ44.3, E80.5, E80.6, E80.4

Documentation: Only one of the components this code’s title joins is documented.

Coding question: Is P58.4 supported?

Path: Review the code for the documented component on its own.

Reason: A combination code is assigned only when it fully identifies the documented conditions; otherwise the documented component takes its own code (Guidelines I.B.9).

Documentation: The underlying condition the Code First note names is documented alongside this condition.

Coding question: How are the two sequenced?

Path: Review the Code First note.

Reason: The underlying condition is sequenced first and the manifestation follows (Guidelines I.A.13).

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.

Code Overview

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). A more specific billable subcode must be selected for claims submission.

MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.

Decision Points

The directives on this code's own record, as a pre-claim checklist.

  1. Sequencing: 1 Code First instruction — the underlying condition is sequenced before this code when present. See the Code First notes
  2. 1 Use Additional Code instruction — report the named additional code(s) when the documentation supports them. See the Use Additional Code notes
  3. 6 Excludes1 entries — codes named there are generally not reported together with this code (Guidelines I.A.12.a). See the Excludes1 notes

Checklist rows are derived from this code's own official directives; the wording of each check is MedCoder editorial. The official notes themselves are in the sections each row links to.

Verify Before Coding

  • Not billable as written — a more specific code is required: P58.41, P58.42.

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

Other codes that name P58.4 or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.

Referenced by 3 Excludes1 notes across 3 chapters: K72 — Hepatic failure, not elsewhere classified (via P58.-), P93 — Reactions and intoxications due to drugs administered to newborn, R17 — Unspecified jaundice (via P58.-).

These codes’ tabular lists mark this diagnosis as mutually exclusive — not reported together unless the conditions are documented as unrelated.

Referenced by 11 Excludes2 notes across 2 chapters: P04 — Newborn affected by noxious substances transmitted via placenta or breast milk, R70 — Elevated erythrocyte sedimentation rate and abnormality of plasma viscosity (via P58.-), R70-R79 — Abnormal findings on examination of blood, without diagnosis (R70-R79) (via P58.-), R71 — Abnormality of red blood cells (via P58.-), R73 — Elevated blood glucose level (via P58.-), R74 — Abnormal serum enzyme levels (via P58.-), R75 — Inconclusive laboratory evidence of human immunodeficiency virus [HIV] (via P58.-), R76 — Other abnormal immunological findings in serum (via P58.-), R77 — Other abnormalities of plasma proteins (via P58.-), R78 — Findings of drugs and other substances, not normally found in blood (via P58.-), R79 — Other abnormal findings of blood chemistry (via P58.-).

These codes’ tabular lists name this diagnosis as distinct — both may be reported when both are documented.

Referenced by 1 Code Also instruction: K76.82 — Hepatic encephalopathy (via P58.-).

These codes suggest coding this condition alongside when both are present.

Contextual Map

Every relationship of P58.4 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.

Run P58.4 with these 20 related codes in Claim Check

Hierarchy

Code First (30)

Use Additional Code (15)

Referenced by Excludes1 notes

Referenced by Excludes2 notes (11)

Referenced by Code Also instructions

Nearest codes (10)

Change history

  • FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016

Common coding questions

Can P58.4 be billed directly?

No. P58.4 (Neonatal jaundice due to drugs or toxins transmitted from mother or given to newborn) is a non-billable ICD-10-CM category code. A more specific billable subcode must be selected based on clinical documentation.

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
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

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Neonatal jaundice due to drugs or toxins transmitted from mother or given to newborn

No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027 (effective October 1, 2026), and none are recorded for this code. Note changes are tracked from FY2027 only.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to P58.4 in its code family, with their registry titles.

View all codes in the P58 family