P35.4Congenital Zika virus disease

P35.4 is the ICD-10-CM diagnosis code for congenital Zika virus disease. It belongs to category P35 (congenital viral diseases), block P35-P39 (infections specific to the perinatal period) and chapter 16 (certain conditions originating in the perinatal period). It is billable, so it can be reported on its own for dates of service from October 1, 2026 through September 30, 2027.

Within P35 (congenital viral diseases), P35.4 is specifically for congenital Zika virus disease. Related codes cover congenital rubella syndrome (P35.0), congenital cytomegalovirus infection (P35.1), congenital herpesviral [herpes simplex] infection (P35.2), congenital viral hepatitis (P35.3), other congenital viral diseases (P35.8) and congenital viral disease, unspecified (P35.9).

Use an additional code to identify manifestations of congenital Zika virus disease.

As a secondary diagnosis it is an MCC (major complication or comorbidity), which can move an inpatient stay into the highest-paying "with MCC" MS-DRG of its family, unless the principal diagnosis excludes it.

In MS-DRG v44.0, it is part of the grouping logic for DRG 791 (Prematurity with Major Problems, relative weight 4.1075) and DRG 793 (Full Term Neonate with Major Problems, relative weight 4.2195), in MDC 15 (Newborns and Other Neonates with Conditions Originating in the Perinatal Period), as a principal or secondary diagnosis. The DRG a claim lands in depends on the principal diagnosis, procedures and any CC/MCC secondary diagnoses.

It was added in FY2019, effective October 1, 2018.