Excludes1 pair
P93- vs P96.2
P93 and P96.2 are not coded together. ICD-10-CM declares them mutually exclusive with an Excludes1 note — the two conditions are not expected to occur together, so exactly one of them is normally correct for a given encounter. The Official Guidelines carve out one exception: if the two conditions are clearly unrelated to each other, both may be reported.
The official note, declared on P93
withdrawal symptoms from therapeutic use of drugs in newborn (P96.2)
P93
Reactions and intoxications due to drugs administered to newborn
Not billable
- Chapter 16
- Certain conditions originating in the perinatal period
- Section
- P90-P96
Use when the record says
- reactions and intoxications due to drugs administered to fetus affecting newborn
P96.2
Withdrawal symptoms from therapeutic use of drugs in newborn
Billable
- Chapter 16
- Certain conditions originating in the perinatal period
- Section
- P90-P96
Indexed under
- Withdrawal state › therapeutic substance, neonatal
- Withdrawal state › newborn › correct therapeutic substance properly administered
- Syndrome › withdrawal › drug › therapeutic use, newborn
Excludes1 is not always absolute: where two conditions covered by the note are genuinely unrelated, CMS guidance permits reporting both. Document the reasoning rather than assuming it. More on Excludes1 vs Excludes2 · FY2027