Fetal alcohol syndrome (FAS) is one of the leading causes of preventable birth defects and developmental disabilities in the United States (1). Since 1979, surveillance systems for estimating and tracking FAS have categorized cases using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM), code 760.71 (2). This code comprises noxious influences affecting the fetus or newborn through placenta or breast milk, specifically alcohol, and includes FAS. Because the code is not specific for FAS and may reflect maternal alcohol consumption during pregnancy or other adverse effects of alcohol on the fetus, CDC assessed the usefulness of this code in ascertaining FAS cases by reviewing medical records for 1981-1993 from the Aberdeen Area Indian Health Service (IHS) and IHS contract facilities in eight of the 19 tribal or American Indian communities in the area. This report summarizes the findings of the analysis.