P04.0 vs P96.1
P04.0 (Newborn affected by maternal anesthesia and analgesia in pregnancy, labor and delivery) compared with P96.1 (Neonatal withdrawal symptoms from maternal use of drugs of addiction), from the official CMS tabular data. Do not report these codes together: the official tabular list marks them Excludes1.
Can these codes be reported together?
No — do not report together. P96.1 carries an Excludes1 note covering P04.0: “reactions and intoxications from maternal opiates and tranquilizers administered during labor and delivery (P04.0)”
Sole exception: when the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).
Side by side
| P04.0Newborn affected by maternal anesthesia and analgesia in pregnancy, labor and delivery | P96.1Neonatal withdrawal symptoms from maternal use of drugs of addiction | |
|---|---|---|
| Billing status | Billable | Billable |
| Classification | P00-P96 — Certain Conditions Originating in the Perinatal Period (P00-P96) | P00-P96 — Certain Conditions Originating in the Perinatal Period (P00-P96) |
| Definition | Newborn affected by maternal anesthesia and analgesia in pregnancy, labor and delivery is a billable ICD-10-CM diagnosis code (P04.0). | Neonatal withdrawal symptoms from maternal use of drugs of addiction is a billable ICD-10-CM diagnosis code (P96.1). |
| Includes | nonteratogenic effects of substances transmitted via placenta Newborn affected by reactions and intoxications from maternal opiates and tranquilizers administered for procedures during pregnancy or labor and delivery | Drug withdrawal syndrome in infant of dependent mother Neonatal abstinence syndrome |
| Code first | any current condition in newborn, if applicable | — |
Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources