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ICD-10-CM 2027 diagnosis code

P04.81Newborn affected by maternal use of cannabis

✓ Billable / specific

P04.81 is a valid, billable ICD-10-CM code for newborn affected by maternal use of cannabis. It can be reported on claims for dates of service from October 1, 2026 – September 30, 2027.

Code last changed in FY2019 (effective October 1, 2018). Source: official FY2027 ICD-10-CM release from CDC/NCHS and CMS. Page updated September 29, 2026. About our data

About P04.81

P04.81 is the ICD-10-CM diagnosis code for newborn affected by maternal use of cannabis. It belongs to category P04 (newborn affected by noxious substances transmitted via placenta or breast milk), block P00-P04 (newborn affected by maternal factors and by complications of pregnancy, labor, and delivery) and chapter 16 (certain conditions originating in the perinatal period). It is billable, so it can be reported on its own for dates of service from October 1, 2026 through September 30, 2027.

Within P04.8 (newborn affected by other maternal noxious substances), P04.81 is specifically for newborn affected by maternal use of cannabis. Related codes cover other maternal noxious substances (P04.89).

Code first: any current condition in newborn, if applicable.

It is not a CC or MCC, so as a secondary diagnosis it doesn't change the MS-DRG severity level.

In MS-DRG v44.0, it is part of the grouping logic for DRG 794 (Neonate with Other Significant Problems, relative weight 1.4935), in MDC 15 (Newborns and Other Neonates with Conditions Originating in the Perinatal Period), as a principal or secondary diagnosis. The DRG a claim lands in depends on the principal diagnosis, procedures and any CC/MCC secondary diagnoses.

It was added in FY2019, effective October 1, 2018.

Notes that apply from higher levels

Instructions written at a parent level also apply to P04.81.

› From P04 Newborn affected by noxious substances transmitted via placenta or breast milk
Includes
  • nonteratogenic effects of substances transmitted via placenta
Excludes2
  • congenital malformations (Q00-Q99)
  • encounter for observation of newborn for suspected diseases and conditions ruled out (Z05.-)
  • neonatal jaundice from excessive hemolysis due to drugs or toxins transmitted from mother (P58.4)
  • newborn in contact with and (suspected) exposures hazardous to health not transmitted via placenta or breast milk (Z77.-)
Code first
  • any current condition in newborn, if applicable

Broader instructions also apply from P00-P04 Newborn affected by maternal factors and by complications of pregnancy, labor, and delivery and Chapter 16: Certain conditions originating in the perinatal period.

Alphabetic index entries

2 entries

Terms in the official ICD-10-CM index that lead to P04.81.

MS-DRG v44.0 grouping

All DRGs →

Inpatient MS-DRGs this diagnosis can group to, as the principal or a secondary diagnosis, depending on the rest of the claim.

MDC 15 · Newborns and Other Neonates with Conditions Originating in the Perinatal Period

Code history

  1. 2016
  2. 2017
  3. 2018
  4. 2019
  5. 2020
  6. 2021
  7. 2022
  8. 2023
  9. 2024
  10. 2025
  11. 2026
  12. 2027
  • FY2019 (effective 10/1/2018): Added
  • No changes since FY2019.

Common questions about P04.81

Is P04.81 billable?

Yes. P04.81 is a billable/specific ICD-10-CM code valid for FY2027 (October 1, 2026 – September 30, 2027).

Can P04.81 be used as a principal diagnosis?

Yes. The Medicare Code Editor doesn't restrict P04.81 as a principal diagnosis.

Is P04.81 a CC or MCC?

No. P04.81 is neither a CC nor an MCC under MS-DRG v44.0.

What DRG does P04.81 group to?

P04.81 is used in the MS-DRG v44.0 logic for MS-DRG 794 (Neonate with Other Significant Problems). Which one applies depends on whether it is the principal diagnosis and on the rest of the claim.