Report Codes for Newborns? Bookmark This Maternal Drug List for Oct. 1, 2018

Opioid use has been getting a lot of attention lately, so it’s worth noting that ICD-10-CM 2019 is all set to include a code for a newborn affected by maternal use of opiates. That code was just one of ICD-10-CM 2019’s new additions in category P04.-. To help you find the right code faster when the codes are effective Oct. 1, 2018, you can use the alphabetical list below.

Tip: The list includes all 2019 ICD-10-CM codes in P04.-, not just changes, so you’ll have all the codes at your fingertips.

Find the Right Reportable Code in This Alphabetical List*

Codes in P04.- (Newborn affected by noxious substances transmitted via placenta or breast milk)

* Other and unspecified codes listed at the end.

  • ALCOHOL
    • Code: P04.3
      • Excludes1:
        • fetal alcohol syndrome (Q86.0)
  • AMPHETAMINES
    • Code: P04.16
  • ANESTHESIA AND ANALGESIA IN PREGNANCY, LABOR, AND DELIVERY
    • Code: P04.0
      • Also applies to:
        • reactions and intoxications from maternal opiates and tranquilizers administered for procedures during pregnancy or labor and delivery
      • Excludes2:
        • newborn affected by other maternal medication (P04.1-)
  • ANTICONVULSANTS
    • Code: P04.13
  • ANTIDEPRESSANTS
    • Code: P04.15
  • ANTINEOPLASTIC CHEMOTHERAPY

    • Code: P04.11
  • ANXIOLYTICS
    • Code: P04.1A
  • CANNABIS
    • Code: P04.81
  • COCAINE
    • Code: P04.41
      • Note: ICD-10-CM includes the term “Crack baby” under this code.
  • CYTOTOXIC DRUGS

    • Code: P04.12
  • ENVIRONMENTAL CHEMICAL SUBSTANCES
    • Code: P04.6
  • HALLUCINOGENS
    • Code: P04.42
      • Excludes2:
        • newborn affected by other maternal medication (P04.1-)
  • NUTRITIONAL CHEMICAL SUBSTANCES
    • Code: P04.5
      • Note: The index points to P04.5 for nutritional supplements.
  • OPIATES
    • Code: P04.14
      • Note: When the condition results from opiates administered for procedures during pregnancy or labor and delivery, the index points you to P04.0 rather than P04.14.
  • SEDATIVE-HYPNOTICS
    • Code: P04.17
  • TOBACCO
    • Code: P04.2
      • Also applies to:
        • exposure in utero to tobacco smoke
      • Excludes2:
        • newborn exposure to environmental tobacco smoke (P96.81)

OTHER AND UNSPECIFIED SUBSTANCE CODES

  • DRUGS OF ADDICTION

    • Other: P04.49
      • Excludes2:
        • newborn affected by maternal anesthesia and analgesia (P04.0)
        • withdrawal symptoms from maternal use of drugs of addiction (P96.1)
      • Note: The index points to P04.49 for methamphetamines.
    • Unspecified: P04.40
  • MEDICATION
    • Other: P04.18
    • Unspecified: P04.19
  • NOXIOUS SUBSTANCES
    • Other: P04.89
    • Unspecified: P04.9

Smart Move: Review These Category Notes to Improve Coding

Remember that code descriptors don’t have all the details. Here are two groups of notes to keep in mind when you start using the 2019 code set.

Category P04.-: These notes apply to all codes that begin with P04.- (Newborn affected by noxious substances transmitted via placenta or breast milk).

  • Includes:
    • nonteratogenic effects of substances transmitted via placenta
  • Excludes2:
    • congenital malformations (Q00-Q99)
    • encounter for observation of newborn for suspected diseases and conditions ruled out (Z05.-)
    • neonatal jaundice from excessive hemolysis due to drugs or toxins transmitted from mother (P58.4)
    • newborn in contact with and (suspected) exposures hazardous to health not transmitted via placenta or breast milk (Z77.-).

Subcategory P04.1-: Codes beginning with P04.1- (Newborn affected by other maternal medication) all have these notes to remember:

  • Code first:
    • withdrawal symptoms from maternal use of drugs of addiction, if applicable (P96.1)
  • Excludes1:
    • dysmorphism due to warfarin (Q86.2)
    • fetal hydantoin syndrome (Q86.1)
  • Excludes2:
    • maternal anesthesia and analgesia in pregnancy, labor and delivery (P04.0)
    • maternal use of drugs of addiction (P04.4-).

What About You?

Will you use these codes? When the physician documents a specific drug, what method do you use to determine the correct category of drug so you can choose the most specific code?

About 

Deborah works on a wide range of TCI SuperCoder projects, researching and writing about coding, as well as assisting with data updates and tool development for our online coding solutions. Since joining TCI in 2004, she’s covered the ins and outs of coding for radiology, cardiology, oncology and hematology, orthopedics, audiology, and more.

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