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Alphabetic Index and Tabular path
HCC Buddy public API, FY2026 Apr updateSource load source requiredSource year 2026Updated 2026-04-01

Index trail

Newborn affected by maternal use of amphetamines

See Tabular List: P04.16

P04, Newborn affected by noxious substances transmitted via placenta or breast milk

P04.1, Newborn affected by other maternal medication

P04.16, Newborn affected by maternal use of amphetamines

Selected code, source checked for the selected effective period

Commonly confused codes

official source

Not listed for this effective period.

Code details and official notes

P04.16

Newborn affected by maternal use of amphetamines

Open the shareable code page for P04.16→
billableHCC mapped

Includes

official source

Not listed for this effective period.

Excludes 1

official source
  • dysmorphism due to warfarin (Q86.2)
  • fetal hydantoin syndrome (Q86.1)

Excludes 2

official source
  • maternal anesthesia and analgesia in pregnancy, labor and delivery (P04.0)
  • maternal use of drugs of addiction (P04.4-)

Code First

official source
  • , if applicable, withdrawal symptoms from maternal use of drugs of addiction (P96.1)
  • withdrawal symptoms from therapeutic use of drugs in newborn (P96.2)

Use Additional

official source

Not listed for this effective period.

Code Also

official source

Not listed for this effective period.

7th character

official source

Not listed for this code in the selected Tabular payload.

Placeholder X

official source

Not listed for this code in the selected Tabular payload.

Laterality

official source

No laterality instruction is listed for this code in the selected Tabular payload.

Effective period

source required
  • FY2026 Apr update
  • Source year 2026
  • Updated 2026-04-01
  • HCC Buddy public API
HCC Buddy
HCC Buddy
Alphabetic Index and Tabular path
HCC Buddy public API, FY2026 Apr updateSource load source requiredSource year 2026Updated 2026-04-01

Index trail

Newborn affected by maternal use of amphetamines

See Tabular List: P04.16

P04, Newborn affected by noxious substances transmitted via placenta or breast milk

P04.1, Newborn affected by other maternal medication

P04.16, Newborn affected by maternal use of amphetamines

Selected code, source checked for the selected effective period

Commonly confused codes

official source

Not listed for this effective period.

Code details and official notes

P04.16

Newborn affected by maternal use of amphetamines

Open the shareable code page for P04.16→
billableHCC mapped

Includes

official source

Not listed for this effective period.

Excludes 1

official source
  • dysmorphism due to warfarin (Q86.2)
  • fetal hydantoin syndrome (Q86.1)

Excludes 2

official source
  • maternal anesthesia and analgesia in pregnancy, labor and delivery (P04.0)
  • maternal use of drugs of addiction (P04.4-)

Code First

official source
  • , if applicable, withdrawal symptoms from maternal use of drugs of addiction (P96.1)
  • withdrawal symptoms from therapeutic use of drugs in newborn (P96.2)

Use Additional

official source

Not listed for this effective period.

Code Also

official source

Not listed for this effective period.

7th character

official source

Not listed for this code in the selected Tabular payload.

Placeholder X

official source

Not listed for this code in the selected Tabular payload.

Laterality

official source

No laterality instruction is listed for this code in the selected Tabular payload.

Effective period

source required
  • FY2026 Apr update
  • Source year 2026
  • Updated 2026-04-01
  • HCC Buddy public API
HCC Buddy Insights

HCC Mapping

HCC 137 Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications (V28)V24 source requiredRxHCC source requiredESRD/PACE source requiredHCC 82 HHS-HCC 82; HHS-HCC 2026 benefit year (HHS-HCC)

RAF Value

V28: RAF: 0.424V24 RAF source requiredRxHCC RAF source requiredESRD/PACE RAF source requiredHHS-HCC: RAF: Varies by metal level

Model Period

FY2026 Apr update

Source

source required

Audit Caution

Close codes need documentation support before selection. Do not assume relationships.
Reviewed by the HCC Buddy Coding Team

HCC Buddy workflow band

HCC mapping, RAF, MEAT, source trail, and audit caution stay in view.

MEAT supportaudit cautionsource required

V28

HCC 137

Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications

RAF: 0.424

HHS-HCC

HCC 82

HHS-HCC 82; HHS-HCC 2026 benefit year

RAF: Varies by metal level

MEAT checklist

Reviewed by the HCC Buddy Coding Team

Monitor, Evaluate, Assess, or Treat must be supported in the provider note.

HCC Buddy guidance, not official ICD-10-CM text.

Audit caution

Reviewed by the HCC Buddy Coding Team

Close codes need documentation support before selection. Do not assume relationships.

HCC Buddy guidance, not official ICD-10-CM text.

Reviewer sign-off

Reviewed by the HCC Buddy Coding Team

MEAT, documentation support, audit cautions, and close-code guidance are reviewed and approved for this effective period.

HCC Buddy enrichment is separate from official source text.

Last updated: April 1, 2026 · Not a substitute for official coding guidelines. No PHI or patient data.
HCC Buddy Code Card
FY 2026 Apr update
P04.16Billable

Newborn affected by maternal use of amphetamines

CMS-HCC V28

HCC 137

RAF 0.424

ACA/HHS

HCC 82

RAF Varies by metal level

Reviewed by the HCC Buddy Coding TeamFY2026 Apr update

Code

P04.16

V28 HCC

HCC 137

RAF

0.424

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