P04
Non-Billable

Is P04 Billable?

No — This is a non-billable / non-specific code. Use a more specific sub-code for billing and reimbursement.

Newborn affected by noxious substances transmitted via placenta or breast milk

Billable Alternatives 6 found
P04.0
Newborn affected by maternal anesthesia and analgesia in pregnancy, labor and delivery
Billable
P04.2
Newborn affected by maternal use of tobacco
Billable
P04.3
Newborn affected by maternal use of alcohol
Billable
P04.5
Newborn affected by maternal use of nutritional chemical substances
Billable
P04.6
Newborn affected by maternal exposure to environmental chemical substances
Billable
P04.9
Newborn affected by maternal noxious substance, unspecified
Billable

Understanding Billable vs Non-Billable Codes

ICD-10-CM codes are classified as either billable/specific or non-billable/non-specific. Billable codes can be used on insurance claims for reimbursement. Non-billable codes are typically parent or header codes that require a more specific sub-code for actual billing.

When a code is non-billable, always look for its child codes (sub-codes) which provide the necessary specificity for reimbursement. Using a non-billable code on a claim may result in denial or delayed payment.

About Billable Status

Billable status indicates whether a code can be used for reimbursement purposes. Non-billable codes are typically header or parent codes that require a more specific sub-code for actual billing and claims. Always verify with the latest payer guidelines.