ICDcodes.org
FY2027

P96.1 — Neonatal withdrawal symptoms from maternal use of drugs of addiction

BillableCC

Is P96.1 billable?

Yes — P96.1 is billable for FY2027. P96.1 is a valid, billable ICD-10-CM code at the highest level of specificity in its branch. P96.1 may be submitted for encounters from October 1, 2026 through September 30, 2027.

P96.1 at a glance

CodeP96.1
DescriptionNeonatal withdrawal symptoms from maternal use of drugs of addiction
BillableYes
Code setICD-10-CM FY2027
Valid for encountersOctober 1, 2026 – September 30, 2027

Which MS-DRGs does P96.1 group to?

P96.1 sits in MDC 15 and helps define the logic of 1 MS-DRG (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.

  • 791Prematurity with Major Problemsmedical

As a secondary diagnosis, P96.1 is a complication or comorbidity (CC), which can move a stay into a higher-paying DRG.

How is P96.1 listed in the Alphabetic Index?

These are the routes through the Alphabetic Index that lead to P96.1. They show the wording a clinician may have documented, which often differs from the Tabular description.

  • Abstinence symptoms, syndrome › neonatal
  • Newborn › abstinence syndrome (infant) (liveborn) (singleton)
  • Syndrome › abstinence, neonatal
  • Syndrome › drug withdrawal, infant of dependent mother
  • Syndrome › neonatal abstinence
  • Newborn › affected by › neonatal abstinence syndrome (infant) (liveborn) (singleton)
  • Withdrawal state › newborn › infant of dependent mother
  • Dependence › drug NEC › cocaine › withdrawal symptoms in newborn (on) (syndrome)
  • Reaction › drug NEC › withdrawal › infant of dependent mother
  • Reaction › drug NEC › withdrawal › newborn
  • Syndrome › withdrawal › drug › infant of dependent mother

Excludes1 — never code together

The conditions below can never be reported together with P96.1 on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.

  • reactions and intoxications from maternal opiates and tranquilizers administered during labor and delivery (P04.0)

Inclusion terms

Alternative wording in documentation that is classified to P96.1.

  • Drug withdrawal syndrome in infant of dependent mother
  • Neonatal abstinence syndrome

Excludes2 — not included here — inherited from Chapter 16

The conditions below are not part of P96.1, but a patient may have both at the same time. When documentation supports it, P96.1 and the excluded code may both be reported.

  • 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)

How long has P96.1 existed?

P96.1 has been in ICD-10-CM since at least FY2016, the earliest fiscal year on record here.

Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.

Which codes are confused with P96.1?

ICD-10-CM declares these codes mutually exclusive with P96.1 — exactly one of each pair can be correct for a given encounter.

Which conditions are coded to P96.1?

What other codes are in the P96 family? (6)