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

Billable ICD-10-CM code, FY2026. Acts as a Complication or Comorbidity (CC) as a secondary diagnosis.

Applicable to

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

Excludes1 (never code together)

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

Risk adjustment (HCC)

• CMS-HCC V28: HCC 137 — Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications

MS-DRG index

Defines the logic of DRG(s) 791 in MDC 15.

Approximate ICD-9-CM (GEMs)

• 779.5 Drug withdrawal syndrome in newborn (approximate)

Code annotations containing back-references to P96.1

Back-references to P96.1

• Code First: P04.1 Newborn affected by other maternal medication (", if applicable, withdrawal symptoms from maternal use of drugs of addiction (P96.1)")
• Type 2 Excludes: P04.49 Newborn affected by maternal use of other drugs of addiction ("withdrawal symptoms from maternal use of drugs of addiction (P96.1)")
• Type 1 Excludes: P93 Reactions and intoxications due to drugs administered to newborn ("withdrawal symptoms from maternal use of drugs of addiction (P96.1)")

Diagnosis Index entries for P96.1

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

Nearby codes

• 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 (this code)
• 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