P04.5
P04.5 — Newborn affected by maternal use of nutritional chemical substances
Billable / specific codeICD-10-CM
P04.5 is a billable, specific ICD-10-CM code for newborn affected by maternal use of nutritional chemical substances. It is valid for submission on a claim.
Risk adjustment
P04.5 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 137 Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications0.424 RAF
Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score.
How P04.5 is indexed
Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to P04.5.
- Newborn›affected by›nutritional supplements
- Absorption›chemical›through placenta›nutritional substance
Related codes at this level
Codes that share P04. If P04.5 is not quite right, the correct code is usually one of these.
- P04.0Newborn affected by maternal anesthesia and analgesia in pregnancy, labor and delivery
- P04.1Newborn affected by other maternal medication
- P04.2Newborn affected by maternal use of tobacco
- P04.3Newborn affected by maternal use of alcohol
- P04.4Newborn affected by maternal use of drugs of addiction
- P04.6Newborn affected by maternal exposure to environmental chemical substances
- P04.8Newborn affected by other maternal noxious substances
- P04.9Newborn affected by maternal noxious substance, unspecified
Questions about P04.5
- Is P04.5 a billable ICD-10-CM code?
- Yes. P04.5 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does P04.5 sit in the tabular list?
- Certain conditions originating in the perinatal period (P00-P96), in the block Newborn affected by maternal factors and by complications of pregnancy, labor, and delivery (P00-P04).