ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 P93

Non-Billable Header

Reactions and intoxications due to drugs administered to newborn

P93
Block
0
Synonyms
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LCDs
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Payer Policies
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Linked CPTs

About ICD-10-CM P93

ICD-10-CM code P93 represents Reactions and intoxications due to drugs administered to newborn. This is a non-billable header code in the Perinatal Period chapter (block P93). The 2026 edition of ICD-10-CM P93 became effective on October 1, 2025. Non-billable codes cannot be used as a primary or secondary diagnosis on a claim, use a more specific child code instead.

Type 1 Excludes

Pure excludes, these codes can never be coded together with P93. The conditions are mutually exclusive (e.g., congenital vs acquired forms).

  • jaundice due to drugs or toxins transmitted from mother or given to newborn (P58.4-)
  • reactions and intoxications from maternal opiates, tranquilizers and other medication (P04.0-P04.1, P04.4-)
  • withdrawal symptoms from maternal use of drugs of addiction (P96.1)
  • withdrawal symptoms from therapeutic use of drugs in newborn (P96.2)

Includes

  • reactions and intoxications due to drugs administered to fetus affecting newborn

Medicare LCD Coverage for P93

Local Coverage Determinations (LCDs) from CMS MACs that list P93 as a covered diagnosis.

No Medicare LCDs reference P93 as covered

This doesn't mean the code isn't covered, it means no MAC has issued a Local Coverage Determination naming this specific code. Coverage may still apply under National Coverage Determinations or general medical-necessity rules.

Commercial Payer Coverage

Coverage policies from major commercial payers referencing P93.

No commercial payer policies reference P93 on file

Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but P93 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.

CPT Codes Commonly Billed with P93

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

No procedure linkages on file for P93

We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.

ICD-10 P93, Billing FAQ

Is ICD-10 code P93 billable? +

No, P93 is a non-billable header code. Use a more specific child code from block P93 when submitting claims.

What codes are Type 1 Excludes for P93? +

Type 1 Excludes (never code together with P93): jaundice due to drugs or toxins transmitted from mother or given to newborn (P58.4-); reactions and intoxications from maternal opiates, tranquilizers and other medication (P04.0-P04.1, P04.4-); withdrawal symptoms from maternal use of drugs of addiction (P96.1)

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Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on May 31, 2026.

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