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P96.81 ICD-10-CM Code: Exposure to (parental) (environmental) tobacco smoke in the perinatal period

Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Coding at a Glance

Tabular directives
2 Excludes2

Inpatient Payment Groups (MS-DRG)

Potential MS-DRG participation — not a DRG assignment.

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v43, Appendix B.

  • MS-DRG 794 — NEONATE WITH OTHER SIGNIFICANT PROBLEMS (MDC 15)

A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for P96.81 in the official ICD-10-CM tabular list, quoted as published.

Excludes2 — Not Included Here

Conditions not covered by this code, but which may be reported alongside it when both are present.

Coder workflow for P96.81

MedCoder structured workflow — derived from this code’s own official record

Documentation check

The provider’s diagnostic statement
Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).

Official instructions as workflow

  • Excludes2 — not part of P96.81(2 notes)

    Coding workflow: The conditions named in this note are not included in P96.81. When the record documents both, both may be reported; the note is a boundary, not a prohibition.

    CompareP04.2, Z77.22

    See the official tabular notes · Guidelines I.A.12.b

Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.

Code Overview

Exposure to (parental) (environmental) tobacco smoke in the perinatal period is a billable ICD-10-CM diagnosis code (P96.81).

MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.

Indexed Clinical Terms (2)

Official source data — entries quoted as published, in the Index’s own lookup phrasing

Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code. These are alphabetic-index entries shown as the Index writes them — lookup phrasing, not necessarily the wording of a final diagnosis.

Verify Before Coding

  • No Medicare Code Editor or MS-DRG Definitions Manual restrictions apply to this code.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.

Relationships & Classification

MedCoder structured relationships — computed from published CMS and AHRQ datasets

Other codes that name P96.81 or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.

Referenced by 2 Excludes2 notes across 2 chapters: P04.2 — Newborn affected by maternal use of tobacco, Z77 — Other contact with and (suspected) exposures hazardous to health.

These codes’ tabular lists name this diagnosis as distinct — both may be reported when both are documented.

Referenced by 27 Use Additional Code instructions across 4 chapters: C07 — Malignant neoplasm of parotid gland, C08 — Malignant neoplasm of other and unspecified major salivary glands, C09 — Malignant neoplasm of tonsil, C10 — Malignant neoplasm of oropharynx, C11 — Malignant neoplasm of nasopharynx, C12 — Malignant neoplasm of pyriform sinus, C13 — Malignant neoplasm of hypopharynx, C14 — Malignant neoplasm of other and ill-defined sites in the lip, oral cavity and pharynx, C32 — Malignant neoplasm of larynx, C33 — Malignant neoplasm of trachea, C34 — Malignant neoplasm of bronchus and lung, C39 — Malignant neoplasm of other and ill-defined sites in the respiratory system and intrathoracic organs, D00.0 — Carcinoma in situ of lip, oral cavity and pharynx, D02 — Carcinoma in situ of middle ear and respiratory system, H65 — Nonsuppurative otitis media, H66 — Suppurative and unspecified otitis media, J37 — Chronic laryngitis and laryngotracheitis, J40 — Bronchitis, not specified as acute or chronic, J41 — Simple and mucopurulent chronic bronchitis, J42 — Unspecified chronic bronchitis, +7 more.

These codes instruct coders to additionally report this code when it applies.

MS-DRG Grouper Relationships (FY2026)

Potential MS-DRG participation — not a DRG assignment.

Not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity.

Named in the grouper logic of 1 MS-DRG: DRG 794 (MDC 15).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Clinical classification (AHRQ CCSR):PNL013 — Other specified and unspecified perinatal conditions (default).

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Related Codes

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Other specified and unspecified perinatal conditions).

P83.6 — Umbilical polyp of newborn, P83.8 — Other specified conditions of integument specific to newborn, P83.81 — Umbilical granuloma, P83.88 — Other specified conditions of integument specific to newborn, P83.9 — Condition of the integument specific to newborn, unspecified, P93.0 — Grey baby syndrome, P93.8 — Other reactions and intoxications due to drugs administered to newborn, P94.0 — Transient neonatal myasthenia gravis, P94.1 — Congenital hypertonia, P94.2 — Congenital hypotonia, P94.8 — Other disorders of muscle tone of newborn, P94.9 — Disorder of muscle tone of newborn, unspecified, P95 — Stillbirth, P96.0 — Congenital renal failure, P96.3 — Wide cranial sutures of newborn, P96.5 — Complication to newborn due to (fetal) intrauterine procedure, P96.82 — Delayed separation of umbilical cord, P96.83 — Meconium staining, P96.89 — Other specified conditions originating in the perinatal period, P96.9 — Condition originating in the perinatal period, unspecified, +74 more

Same Index main term, other category

The ICD-10-CM Index to Diseases and Injuries files this code under the main term “Exposure”; these codes share that main term but sit in a different category of the Tabular List.

T69.8 — Other specified effects of reduced temperature (cold, effects of, specified effect NEC), T69.9 — Effect of reduced temperature, unspecified (cold, effects of), T73.2 — Exhaustion due to exposure (exhaustion due to), T73.9 — Effect of deprivation, unspecified (effects of), T75.89 — Other specified effects of external causes, Z20.01 — Contact with and (suspected) exposure to intestinal infectious diseases due to Escherichia coli (E. coli) (Escherichia coli), Z20.09 — Contact with and (suspected) exposure to other intestinal infectious diseases (cholera), Z20.1 — Contact with and (suspected) exposure to tuberculosis (tuberculosis), Z20.2 — Contact with and (suspected) exposure to infections with a predominantly sexual mode of transmission (syphilis), Z20.3 — Contact with and (suspected) exposure to rabies (rabies), Z20.4 — Contact with and (suspected) exposure to rubella (rubella), Z20.6 — Contact with and (suspected) exposure to human immunodeficiency virus [HIV] (AIDS virus), Z20.7 — Contact with and (suspected) exposure to pediculosis, acariasis and other infestations (acariasis), Z20.810 — Contact with and (suspected) exposure to anthrax (anthrax), Z20.811 — Contact with and (suspected) exposure to meningococcus (meningococcus), Z20.818 — Contact with and (suspected) exposure to other bacterial communicable diseases (bacterial disease NEC), Z20.820 — Contact with and (suspected) exposure to varicella (varicella), Z20.821 — Contact with and (suspected) exposure to Zika virus (Zika virus), Z20.822 — Contact with and (suspected) exposure to COVID-19 (COVID-19), Z20.828 — Contact with and (suspected) exposure to other viral communicable diseases (viral disease NEC), +46 more

Contextual Map

Every relationship of P96.81 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Run P96.81 with these 11 related codes in Claim Check

Hierarchy

Excludes2

Referenced by Excludes2 notes

Referenced by Use Additional Code instructions (27)

Clinical classification (CCSR)

MS-DRG Grouper

MDC crossing

Index entries

  • Exposure (to), second hand tobacco smoke (acute) (chronic), in the perinatal period[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Second hand tobacco smoke exposure (acute) (chronic), in the perinatal period[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026

Nearest codes (11)

Change history

  • FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016

Sources for this page

Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.

Code, title, tabular notes and index terms Official source data
CMS/CDC ICD-10-CM FY2026 tabular list, index and tables, effective October 1, 2025 Release, file and checksum · Publisher’s page
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v43.1 (April 2026) Release, file and checksum · Publisher’s page
Inpatient payment groups Official source data
CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v43 Release, file and checksum · Publisher’s page
Change history and date-of-service validity Official source data
CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page
Comparisons, relationships and the contextual map MedCoder structured relationship
Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
Summary and FAQ answers MedCoder explanation
Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.

Labels on this page: Official source data · MedCoder structured relationship · MedCoder explanation. How to read the labels · All data sources and release dates

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Exposure to (parental) (environmental) tobacco smoke in the perinatal period

No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027 (effective October 1, 2026), and none are recorded for this code. Note changes are tracked from FY2027 only.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to P96.81 in its code family, with their registry titles.

View all codes in the P96 family