2026 ICD-10-CM Diagnosis Code P04.16Newborn affected by maternal use of amphetamines

ICD-10-CM Codes›P00–P96›P00-P04›P04

ICD-10-CM P04.16
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

P04.16 is a billable ICD-10-CM diagnosis code for newborn affected by maternal use of amphetamines. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026). In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Neonatal abstinence syndrome and Newborn affected by maternal conditions or complications of labor/delivery.

Code Identity

ICD-10-CM Code
P04.16
Billable Status
Yes — Valid for Submission
Code Describes
Newborn affected by maternal use of amphetamines
Short Description
Newborn affected by maternal use of amphetamines
Same as the full description in the CMS dataset.
Parent Code
P04.1
Newborn affected by other maternal medication

Code Classification

ChapterP00–P96Certain conditions originating in the perinatal period
SectionP00-P04Newborn affected by maternal factors and by complications of pregnancy, labor, and delivery
CategoryP04Newborn affected by noxious substances transmitted via placenta or breast milk
This CodeP04.16Newborn affected by maternal use of amphetamines

Index to Diseases and InjuriesGuidance

Alphabetical index entries that point to this code.

External Cause of Injuries IndexGuidance

References for this code in the External Cause of Injuries Index.

    • Newborn(infant) (liveborn) (singleton)
      • affected by
        • maternal (complication of) (use of)
          • amphetamines

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR PNL014
Neonatal abstinence syndrome
Default principal diagnosis: inpatient Yes · outpatient Yes
CCSR PNL010
Newborn affected by maternal conditions or complications of labor/delivery
Default principal diagnosis: inpatient No · outpatient No

Code History & ChangesHistory

Replacement P04.16 replaces the following previously assigned code(s):

  • P04.1 - Newborn affected by oth maternal medication
  • P04.1 - Newborn affected by other maternal medication
FY 2019AddedAdded to the ICD-10-CM code setEffective October 1, 2018.
FY 2020–2025No changes
FY 2026CurrentCurrent code set, no changesEffective October 1, 2025 through September 30, 2026.

Questions About P04.16Overview

Is P04.16 (Newborn affected by other maternal medication) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report newborn affected by maternal use of amphetamines on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

Footnotes

[1] Chronic - a chronic condition code indicates a condition lasting 12 months or longer and its effect on the patient based on one or both of the following criteria:

  • The condition results in the need for ongoing intervention with medical products,treatment, services, and special equipment
  • The condition places limitations on self-care, independent living, and social interactions.