2020 ICD-10-CM Diagnosis Code P96.1

Neonatal withdrawal symptoms from maternal use of drugs of addiction

    2016 2017 2018 2019 2020 Billable/Specific Code Code on Newborn Record
  • P96.1 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.
  • Short description: Neonatal w/drawal symp from matern use of drugs of addiction
  • The 2020 edition of ICD-10-CM P96.1 became effective on October 1, 2019.
  • This is the American ICD-10-CM version of P96.1 - other international versions of ICD-10 P96.1 may differ.
ICD-10-CM Coding Rules
  • P96.1 should be used on the newborn record - not on the maternal record.
Applicable To
  • Drug withdrawal syndrome in infant of dependent mother
  • Neonatal abstinence syndrome
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 P96.1. 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.
  • reactions and intoxications from maternal opiates and tranquilizers administered during labor and delivery (
    ICD-10-CM Diagnosis Code P04.0

    Newborn affected by maternal anesthesia and analgesia in pregnancy, labor and delivery

      2016 2017 - Revised Code 2018 2019 2020 Billable/Specific Code Code on Newborn Record
    Applicable To
    • Newborn affected by reactions and intoxications from maternal opiates and tranquilizers administered for procedures during pregnancy or labor and delivery
    Type 2 Excludes
    • newborn affected by other maternal medication (P04.1-)
    P04.0
    )
The following code(s) above P96.1 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 P96.1:
  • 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
Approximate Synonyms
  • Neonatal drug withdrawal syndrome, maternal drug abuse
  • Neonatal drug withdrawal syndrome, maternal drugs of abuse
Clinical Information
  • A constellation of signs and symptoms observable in a neonate that are consistent with maternal substance abuse or withdrawal while pregnant.
  • Fetal and neonatal addiction and withdrawal as a result of the mother's dependence on drugs during pregnancy. Withdrawal or abstinence symptoms develop shortly after birth. Symptoms exhibited are loud, high-pitched crying, sweating, yawning and gastrointestinal disturbances.
ICD-10-CM P96.1 is grouped within Diagnostic Related Group(s) (MS-DRG v37.0):
  • 791 Prematurity with major problems
  • 793 Full term neonate with major problems

Convert P96.1 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): No change
  • 2018 (effective 10/1/2017): No change
  • 2019 (effective 10/1/2018): No change
  • 2020 (effective 10/1/2019): No change
Code annotations containing back-references to P96.1:
  • Code First: P04.1
    ICD-10-CM Diagnosis Code P04.1

    Newborn affected by other maternal medication

      2016 2017 - Revised Code 2018 2019 - Converted to Parent Code 2020 Non-Billable/Non-Specific Code
    Code First
    • withdrawal symptoms from maternal use of drugs of addiction, if applicable (P96.1)
    Type 1 Excludes
    • dysmorphism due to warfarin (Q86.2)
    • fetal hydantoin syndrome (Q86.1)
    Type 2 Excludes
    • maternal anesthesia and analgesia in pregnancy, labor and delivery (P04.0)
    • maternal use of drugs of addiction (P04.4-)
  • Type 1 Excludes: P93
    ICD-10-CM Diagnosis Code P93

    Reactions and intoxications due to drugs administered to newborn

      2016 2017 2018 2019 2020 Non-Billable/Non-Specific Code
    Includes
    • reactions and intoxications due to drugs administered to fetus affecting newborn
    Type 1 Excludes
    • jaundice due to drugs or toxins transmitted from mother or given to newborn (P58.4-)
    • reactions and intoxications from maternal opiates, tranquilizers and other medication (P04.0-P04.1, P04.4-)
    • withdrawal symptoms from maternal use of drugs of addiction (P96.1)
    • withdrawal symptoms from therapeutic use of drugs in newborn (P96.2)
  • Type 2 Excludes: P04.49
    ICD-10-CM Diagnosis Code P04.49

    Newborn affected by maternal use of other drugs of addiction

      2016 2017 - Revised Code 2018 2019 2020 Billable/Specific Code Code on Newborn Record
    Type 2 Excludes
    • newborn affected by maternal anesthesia and analgesia (P04.0)
    • withdrawal symptoms from maternal use of drugs of addiction (P96.1)

Diagnosis Index entries containing back-references to P96.1:
  • Abstinence symptoms, syndrome
    • neonatal P96.1
  • Dependence (on) (syndrome) F19.20
    ICD-10-CM Diagnosis Code F19.20

    Other psychoactive substance dependence, uncomplicated

      2016 2017 2018 2019 2020 Billable/Specific Code
    Applicable To
    • Other (or unknown) substance use disorder, moderate
    • Other (or unknown) substance use disorder, severe
    • drug NEC F19.20
      ICD-10-CM Diagnosis Code F19.20

      Other psychoactive substance dependence, uncomplicated

        2016 2017 2018 2019 2020 Billable/Specific Code
      Applicable To
      • Other (or unknown) substance use disorder, moderate
      • Other (or unknown) substance use disorder, severe
      • cocaine F14.20
        ICD-10-CM Diagnosis Code F14.20

        Cocaine dependence, uncomplicated

          2016 2017 2018 2019 2020 Billable/Specific Code
        Applicable To
        • Cocaine use disorder, moderate
        • Cocaine use disorder, severe
        • withdrawal symptoms in newborn P96.1
  • 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
    • affected by
      • neonatal abstinence syndrome P96.1
    • abstinence syndrome P96.1
  • Reaction - see also Disorder
    • drug NEC T88.7
      ICD-10-CM Diagnosis Code T88.7

      Unspecified adverse effect of drug or medicament

        2016 2017 2018 2019 2020 Non-Billable/Non-Specific Code
      Applicable To
      • Drug hypersensitivity NOS
      • Drug reaction NOS
      Type 1 Excludes
      Use Additional
      • code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5)
  • Syndrome - see also Disease
    • withdrawal - see Withdrawal, state
      • drug
        • infant of dependent mother P96.1
    • abstinence, neonatal P96.1
    • drug withdrawal, infant of dependent mother P96.1
    • neonatal abstinence P96.1
  • Withdrawal state - see also Dependence, drug by type, with withdrawal
    • newborn
      • infant of dependent mother P96.1

ICD-10-CM Codes Adjacent To P96.1
P93.8 Other reactions and intoxications due to drugs administered to newborn
P94 Disorders of muscle tone of newborn
P94.0 Transient neonatal myasthenia gravis
P94.1 Congenital hypertonia
P94.2 Congenital hypotonia
P94.8 Other disorders of muscle tone of newborn
P94.9 Disorder of muscle tone of newborn, unspecified
P95 Stillbirth
P96 Other conditions originating in the perinatal period
P96.0 Congenital renal failure
P96.1 Neonatal withdrawal symptoms from maternal use of drugs of addiction
P96.2 Withdrawal symptoms from therapeutic use of drugs in newborn
P96.3 Wide cranial sutures of newborn
P96.5 Complication to newborn due to (fetal) intrauterine procedure
P96.8 Other specified conditions originating in the perinatal period
P96.81 Exposure to (parental) (environmental) tobacco smoke in the perinatal period
P96.82 Delayed separation of umbilical cord
P96.83 Meconium staining
P96.89 Other specified conditions originating in the perinatal period
P96.9 Condition originating in the perinatal period, unspecified
Q00 Anencephaly and similar malformations

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