P96.1
Neonatal withdrawal symptoms from maternal use of drugs of addiction
P96.1 (also written P961) is a billable ICD-10-CM diagnosis code for neonatal withdrawal symptoms from maternal use of drugs of addiction. It is part of the FY2027 code set, effective October 1, 2026. It is one of the 10 codes in category P96 (Other conditions originating in the perinatal period). The Alphabetic Index lists it under 11 entries. Its coding notes include 1 Excludes1 entry and 5 Excludes2 entries.
Guidelines tip
From the FY2027 Official Guidelines. ICD10Ref adds no rules of its own.
Chapter 16 codes are never used on the maternal record, and chapter 15 codes are never used on the newborn record. Chapter 16 codes can be used for life if the condition persists.
Excludes1
Not coded here. The listed conditions generally should not be reported together.
- reactions and intoxications from maternal opiates and tranquilizers administered during labor and delivery (P04.0)
Excludes2
Not included here. Both codes may be reported if the patient has both conditions.
Also from chapter/block level (5 notes)
- 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)
Care settings
How CMS programs treat this code. These are CMS claim edits and list entries, not coverage or eligibility rules.
Home Health Primary
Accepted as the primary (principal) diagnosis on a home health claim. The Home Health Grouper assigns it to the MMTA - Other clinical group.
Source: CMS Home Health Grouper Software v07.2.26, effective October 1, 2026Hospital CC
Counts as a complication or comorbidity (CC) when reported as a secondary diagnosis on an inpatient claim. It does not count when the principal diagnosis is one of the 4 codes in its exclusion list. Some MS-DRGs also ignore a CC or MCC that defines the DRG.
Source: CMS MS-DRG Definitions Manual v44, effective October 1, 2026, Appendix CIncludes
Further defines or gives examples of the content of the category.
Also from chapter/block level (1 note)
- 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
Inclusion terms
Conditions classified to this code.
- Drug withdrawal syndrome in infant of dependent mother
- Neonatal abstinence syndrome
Notes
Also from chapter/block level (1 note)
- Codes from this chapter are for use on newborn records only, never on maternal records
Alphabetic Index terms
Terms the official Alphabetic Index lists for this code. 11 entries
- 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