2020 ICD-10-CM Diagnosis Code P04.3

Newborn affected by maternal use of alcohol

    2016 2017 - Revised Code 2018 2019 2020 Billable/Specific Code Code on Newborn Record
  • P04.3 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.
  • The 2020 edition of ICD-10-CM P04.3 became effective on October 1, 2019.
  • This is the American ICD-10-CM version of P04.3 - other international versions of ICD-10 P04.3 may differ.
ICD-10-CM Coding Rules
  • P04.3 should be used on the newborn record - not on the maternal record.
Type 1 Excludes
Type 1 Excludes Help
A type 1 excludes note is a pure excludes. It means "not coded here". A type 1 excludes note indicates that the code excluded should never be used at the same time as P04.3. A type 1 excludes note is for used for when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition.
  • fetal alcohol syndrome (
    ICD-10-CM Diagnosis Code Q86.0

    Fetal alcohol syndrome (dysmorphic)

      2016 2017 2018 2019 2020 Billable/Specific Code POA Exempt
    Q86.0
    )
The following code(s) above P04.3 contain annotation back-references
Annotation Back-References
In this context, annotation back-references refer to codes that contain:
  • Applicable To annotations, or
  • Code Also annotations, or
  • Code First annotations, or
  • Excludes1 annotations, or
  • Excludes2 annotations, or
  • Includes annotations, or
  • Note annotations, or
  • Use Additional annotations
that may be applicable to P04.3:
  • P00-P96
    2020 ICD-10-CM Range P00-P96

    Certain conditions originating in the perinatal period

    Includes
    • conditions that have their origin in the fetal or perinatal period (before birth through the first 28 days after birth) even if morbidity occurs later
    Note
    • Codes from this chapter are for use on newborn records only, never on maternal records
    Type 2 Excludes
    • congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)
    • endocrine, nutritional and metabolic diseases (E00-E88)
    • injury, poisoning and certain other consequences of external causes (S00-T88)
    • neoplasms (C00-D49)
    • tetanus neonatorum (A33)
    Certain conditions originating in the perinatal period
  • P00-P04
    2020 ICD-10-CM Range P00-P04

    Newborn affected by maternal factors and by complications of pregnancy, labor, and delivery

    Note
    • These codes are for use when the listed maternal conditions are specified as the cause of confirmed morbidity or potential morbidity which have their origin in the perinatal period (before birth through the first 28 days after birth).
    Newborn affected by maternal factors and by complications of pregnancy, labor, and delivery
  • P04
    ICD-10-CM Diagnosis Code P04

    Newborn affected by noxious substances transmitted via placenta or breast milk

      2016 2017 - Revised Code 2018 2019 2020 Non-Billable/Non-Specific Code
    Includes
    • nonteratogenic effects of substances transmitted via placenta
    Type 2 Excludes
    • 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.-)
    Newborn affected by noxious substances transmitted via placenta or breast milk
Approximate Synonyms
  • Newborn affected by maternal alcohol use
Clinical Information
  • A condition occurring in fetus or newborn due to in utero ethanol exposure when mother consumed alcohol during pregnancy. It is characterized by a cluster of irreversible birth defects including abnormalities in physical, mental, and behavior development (such as fetal growth retardation; mental retardation; attention deficit and disruptive behavior disorders) with varied degree of severity in an individual.
  • A syndrome that can develop in infants whose mothers consumed alcohol during pregnancy. Manifestations of this syndrome include low birth weight, failure to thrive, developmental defects, organ dysfunction, mental deficiencies, behavioral problems and poor motor coordination.
  • Alcohol can harm your baby at any stage during a pregnancy. That includes the earliest stages before you even know you are pregnant. Drinking alcohol can cause a group of conditions called fetal alcohol spectrum disorders (fasds).effects can include physical and behavioral problems such as trouble with
    • learning and remembering
    • understanding and following directions
    • controlling emotions
    • communicating and socializing
    • daily life skills, such as feeding and bathing
    fetal alcohol syndrome is the most serious type of fasd. People with fetal alcohol syndrome have facial abnormalities, including wide-set and narrow eyes, growth problems and nervous system abnormalities.fasds last a lifetime. There is no cure for fasds. Treatments can help. These include medicines to help with some symptoms and behavior therapy. No one treatment is right for every child. Centers for Disease Control and Prevention.
  • Developmental abnormalities in infants born to alcoholic mothers, including characteristic facial appearance (microcephaly, maxillary hypoplasia, short palpebral fissures, and short upturned nose), growth deficiency, delayed intellectual development, motor retardation, joint abnormalities, poor coordination, and irritability. The pattern of abnormalities varies and may include additional oral, ocular, cardiac, urogenital, cutaneous, and other abnormalities.
  • Disorder occurring in children born to alcoholic women who continue to drink heavily during pregnancy; common abnormalities are growth deficiency (prenatal and postnatal), altered morphogenesis, mental deficiency, and characteristic facies - small eyes and flattened nasal bridge; fine motor dysfunction and tremulousness are observed in the newborn.
ICD-10-CM P04.3 is grouped within Diagnostic Related Group(s) (MS-DRG v37.0):
  • 794 Neonate with other significant problems

Convert P04.3 to ICD-9-CM

Code History
  • 2016 (effective 10/1/2015): New code (first year of non-draft ICD-10-CM)
  • 2017 (effective 10/1/2016): Revised code
    • New description: Newborn affected by maternal use of alcohol
    • 2016 description: Newborn (suspected to be) affected by maternal use of alcohol
  • 2018 (effective 10/1/2017): No change
  • 2019 (effective 10/1/2018): No change
  • 2020 (effective 10/1/2019): No change

Diagnosis Index entries containing back-references to P04.3:
  • Newborn (infant) (liveborn) (singleton) Z38.2
    ICD-10-CM Diagnosis Code Z38.2

    Single liveborn infant, unspecified as to place of birth

      2016 2017 2018 2019 2020 Billable/Specific Code Newborn/Neonate Dx (0 years) POA Exempt
    Applicable To
    • Single liveborn infant NOS

ICD-10-CM Codes Adjacent To P04.3
P04.12 Newborn affected by maternal cytotoxic drugs
P04.13 Newborn affected by maternal use of anticonvulsants
P04.14 Newborn affected by maternal use of opiates
P04.15 Newborn affected by maternal use of antidepressants
P04.16 Newborn affected by maternal use of amphetamines
P04.17 Newborn affected by maternal use of sedative-hypnotics
P04.1A Newborn affected by maternal use of anxiolytics
P04.18 Newborn affected by other maternal medication
P04.19 Newborn affected by maternal use of unspecified medication
P04.2 Newborn affected by maternal use of tobacco
P04.3 Newborn affected by maternal use of alcohol
P04.4 Newborn affected by maternal use of drugs of addiction
P04.40 Newborn affected by maternal use of unspecified drugs of addiction
P04.41 Newborn affected by maternal use of cocaine
P04.42 Newborn affected by maternal use of hallucinogens
P04.49 Newborn affected by maternal use of other drugs of addiction
P04.5 Newborn affected by maternal use of nutritional chemical substances
P04.6 Newborn affected by maternal exposure to environmental chemical substances
P04.8 Newborn affected by other maternal noxious substances
P04.81 Newborn affected by maternal use of cannabis
P04.89 Newborn affected by other maternal noxious substances

Reimbursement claims with a date of service on or after October 1, 2015 require the use of ICD-10-CM codes.