ICD-10 · PDGM grouping
P96 Other conditions originating in the perinatal period
All 10 codes in the P96 family, with the PDGM clinical group, comorbidity subgroup and primary-position rule CMS assigns, read from the CMS grouper crosswalk v07.2.26 and the CDC FY2027 code file.
Codes in family
10
Can lead a claim
8
Cannot lead a claim
2
What CMS assigns to P96
8 of the 10 codes group to MMTA - Other; 2 are assigned no clinical group. None of the 10 is assigned a comorbidity subgroup. 8 of the 10 can lead a claim.
Every code in P96
Descriptions are CDC’s FY2027 wording; where CMS’s grouper abbreviates one, its form is shown beneath.
| Code | Description | Primary position | Clinical group | Comorbidity subgroup |
|---|---|---|---|---|
| P96.0 | Congenital renal failure | Can lead a claim | A | None |
| P96.1 | Neonatal withdrawal symptoms from maternal use of drugs of addictionCMS: Neonatal w/drawal symp from matern use of drugs of addiction | Can lead a claim | A | None |
| P96.2 | Withdrawal symptoms from therapeutic use of drugs in newborn | Can lead a claim | A | None |
| P96.3 | Wide cranial sutures of newborn | Can lead a claim | A | None |
| P96.5 | Complication to newborn due to (fetal) intrauterine procedureCMS: Comp to newborn due to (fetal) intrauterine procedure | Can lead a claim | A | None |
| P96.8 Other specified conditions originating in the perinatal period | ||||
| P96.81 | Exposure to (parental) (environmental) tobacco smoke in the perinatal periodCMS: Expsr to (environmental) tobacco smoke in the perinat period | Can lead a claim | A | None |
| P96.82 | Delayed separation of umbilical cord | Can lead a claim | A | None |
| P96.83 | Meconium staining | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| P96.89 | Other specified conditions originating in the perinatal periodCMS: Oth conditions originating in the perinatal period | Can lead a claim | A | None |
| P96.9 | Condition originating in the perinatal period, unspecified | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
Sources: CMS HH PPS Grouper Software v07.2.26, effective 2026-10-01, for the clinical group, comorbidity subgroup, code-first conventions and primary-position flags; CDC NCHS ICD-10-CM FY2027 code descriptions for the family title and code wording. This is the crosswalk Medicare runs a claim through. Grouping also depends on admission source, timing, the OASIS functional items and the rest of the diagnosis list.
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