ICD-10 P04.9
Billable / SpecificNewborn affected by maternal noxious substance, unspecified
About ICD-10-CM P04.9
ICD-10-CM code P04.9 represents Newborn affected by maternal noxious substance, unspecified. This is a billable/specific code in the Perinatal Period chapter (block P04). The 2026 edition of ICD-10-CM P04.9 became effective on October 1, 2025.
Medicare LCD Coverage for P04.9
Local Coverage Determinations (LCDs) from CMS MACs that list P04.9 as a covered diagnosis.
This doesn't mean the code isn't covered, it means no MAC has issued a Local Coverage Determination naming this specific code. Coverage may still apply under National Coverage Determinations or general medical-necessity rules.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing P04.9.
1 Cigna
CPT Codes Commonly Billed with P04.9
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.
Convert P04.9 to ICD-9-CM
Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.
| ICD-10 | ICD-9 | Mapping Flags |
|---|---|---|
| P04.9 | 76070 | 10000 |
| P04.9 | 76079 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To P04.9
Other codes in section P00-P04 (Newborn affected by maternal factors and by complications of pregnancy, labor, and delivery).
ICD-10 P04.9, Billing FAQ
Is ICD-10 code P04.9 billable? +
Yes, P04.9 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
What ICD-9 codes does P04.9 map to? +
Per CMS GEMs, P04.9 maps to ICD-9 codes: 76070, 76079. Useful for legacy data review and historical claim analysis.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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