P04.11 Newborn affected by maternal antineoplastic chemotherapy

Billable ICD-10-CM code, FY2026.

Applies from P04 Newborn affected by noxious substances transmitted via placenta or breast milk

Includes

• nonteratogenic effects of substances transmitted via placenta

Excludes2 (not included here)

• 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.-)

Code first

• any current condition in newborn, if applicable

Applies from P04.1 Newborn affected by other maternal medication

Excludes1 (never code together)

• dysmorphism due to warfarin (Q86.2)
• fetal hydantoin syndrome (Q86.1)

Excludes2 (not included here)

• maternal anesthesia and analgesia in pregnancy, labor and delivery (P04.0)
• maternal use of drugs of addiction (P04.4-)

Code first

• , if applicable, withdrawal symptoms from maternal use of drugs of addiction (P96.1)
• withdrawal symptoms from therapeutic use of drugs in newborn (P96.2)

Risk adjustment (HCC)

• CMS-HCC V28: HCC 137 — Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications

MS-DRG index

Defines the logic of DRG(s) 794 in MDC 15.

Code annotations containing back-references to P04.11

Back-references to P04.1

• Type 2 Excludes: P04.0 Newborn affected by maternal anesthesia and analgesia in pregnancy, labor and delivery ("newborn affected by other maternal medication (P04.1-)")
• Type 2 Excludes: P04.42 Newborn affected by maternal use of hallucinogens ("newborn affected by other maternal medication (P04.1-)")
• Type 1 Excludes: P93 Reactions and intoxications due to drugs administered to newborn ("reactions and intoxications from maternal opiates, tranquilizers and other medication (P04.0-P04.1, P04.4-)")

Back-references to P04

• Type 2 Excludes: P00 Newborn affected by maternal conditions that may be unrelated to present pregnancy ("newborn affected by noxious substances transmitted via placenta or breast milk (P04.-)")
• Type 2 Excludes: Q86 Congenital malformation syndromes due to known exogenous causes, not elsewhere classified ("nonteratogenic effects of substances transmitted via placenta or breast milk (P04.-)")
• Type 2 Excludes: Z77 Other contact with and (suspected) exposures hazardous to health ("newborn affected by noxious substances transmitted via placenta or breast milk (P04.-)")

Diagnosis Index entries for P04.11

• Newborn (infant) (liveborn) (singleton) › affected by › chemotherapy agents
• Newborn (infant) (liveborn) (singleton) › affected by › maternal (complication of) (use of) › antineoplastic chemotherapy

Nearby codes

• P04 Newborn affected by noxious substances transmitted via placenta or breast milk
• P04.0 Newborn affected by maternal anesthesia and analgesia in pregnancy, labor and delivery
• P04.1 Newborn affected by other maternal medication
• P04.11 Newborn affected by maternal antineoplastic chemotherapy (this code)
• 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