Non-Billable / Non-Specific Code
ICD-10-CM P04.1 is the diagnosis code for Newborn affected by other maternal medication. This code falls under the section "Newborn affected by maternal factors and by complications of pregnancy, labor, and delivery" within Chapter 16 â Certain conditions originating in the perinatal period (P00-P96). It is a non-billable/non-specific ICD-10-CM code that should not be used for reimbursement. A more specific sub-code is required for billing. Medical coders and healthcare providers use this code to document and classify diagnoses in electronic health records, insurance claims, and clinical databases.
The following conditions should never be coded at the same time as P04.1. They are mutually exclusive:
The following conditions are not included in P04.1. If the patient has both, code each condition separately:
Understanding where P04.1 sits in the ICD-10-CM classification helps ensure proper coding:
No, P04.1 is a non-billable/non-specific code. You should use a more specific sub-code for billing and reimbursement.
P04.1 is the ICD-10-CM diagnosis code for "Newborn affected by other maternal medication". It is used by healthcare providers to classify and document this condition in medical records and insurance claims.
The parent code of P04.1 is P04 ("Newborn affected by noxious substances transmitted via placenta or breast milk"). P04.1 provides a more specific classification within this category.
P04.1 is located in Section P00-P04 â "Newborn affected by maternal factors and by complications of pregnancy, labor, and delivery" within Chapter 16 of the ICD-10-CM Tabular List.
P04.1 has 10 sub-code(s) that provide more specific detail: P04.11, P04.12, P04.13, P04.14, P04.15 and more.
Use P04.1 when the patients documented diagnosis matches "Newborn affected by other maternal medication" and the clinical documentation supports this level of specificity. Always verify with the latest ICD-10-CM guidelines and payer requirements.
The ICD-10-CM code for Newborn affected by other maternal medication is P04.1.
No, P04.1 is non-billable. Use a more specific sub-code for primary diagnosis billing.
P04.1 is in Chapter 16 of the ICD-10-CM Tabular List.
Type 1 Excludes for P04.1 include: dysmorphism due to warfarin (Q86.2); fetal hydantoin syndrome (Q86.1).
Yes, P04.1 is a valid ICD-10-CM code for the 2026 fiscal year, subject to official CMS updates.