P96.81 ICD-10-CM Code: Exposure to (parental) (environmental) tobacco smoke in the perinatal period
P96.81 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · HCC Buddy coding tools
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FY 2026 Apr update / Certain conditions originating in the perinatal period (P00-P96) / Other disorders originating in the perinatal period (P90-P96)
P96.81
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceExposure to (parental) (environmental) tobacco smoke in the perinatal period
A newborn was exposed to secondhand tobacco smoke from parents or the environment during pregnancy or shortly after birth.
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
HistoricalHistorical
Not used for CY2026 payment
ACA/HHS
N/A—
Not mapped
ESRD/PACE
N/A—
Not mapped
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
OfficialNo inclusion terms are included in this display for P96.81. Check the code and parent instructions in the Code Book.
Excludes 2
Official- newborn affected by in utero exposure to tobacco (P04.2)
- exposure to environmental tobacco smoke after the perinatal period (Z77.22)
- congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)Inherited from P00-P96
- endocrine, nutritional and metabolic diseases (E00-E88)Inherited from P00-P96
- injury, poisoning and certain other consequences of external causes (S00-T88)Inherited from P00-P96
- neoplasms (C00-D49)Inherited from P00-P96
- tetanus neonatorum (A33)Inherited from P00-P96
Related Codes
Includes
Official- conditions that have their origin in the fetal or perinatal period (before birth through the first 28 days after birth) even if morbidity occurs laterInherited from P00-P96
Excludes 1
OfficialNo Excludes 1 notes are included in this display for P96.81. Check the code and parent instructions in the Code Book.
Code First
OfficialNo Code First sequencing instructions are included in this display for P96.81. Check the code and parent instructions in the Code Book.
Use Additional
OfficialNo Use Additional Code instructions are included in this display for P96.81. Check the code and parent instructions in the Code Book.
Code Also
OfficialNo Code Also instructions are included in this display for P96.81. Check the code and parent instructions in the Code Book.
Buddy Documentation Tip
Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →
Is P96.81 an HCC code?
No. P96.81 is a billable ICD-10-CM code with no mapping under the current CMS-HCC V28 community payment model, and none under the ESRD, Part D RxHCC, or HHS-HCC models.
- Code
- P96.81
- Description
- Exposure to (parental) (environmental) tobacco smoke in the perinatal period
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF reference coefficient
- —
- Billable
- Yes
- Payment year
- 2026
Coder workflow notes
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What This Code Means
P96.81 is the ICD-10-CM diagnosis code for exposure to (parental) (environmental) tobacco smoke in the perinatal period. A newborn was exposed to secondhand tobacco smoke from parents or the environment during pregnancy or shortly after birth. P96.81 sits in the ICD-10-CM chapter for certain conditions originating in the perinatal period (p00-p96), within the section covering other disorders originating in the perinatal period (p90-p96).
P96.81 is a billable ICD-10-CM code, but no current CMS-HCC V28 community payment mapping is shown, and none under the ESRD, Part D RxHCC, or HHS-HCC models. Do not assign risk adjustment value from this page when no source-backed mapping is shown; verify the applicable model and payment year.
This is an exposure code; document whether exposure occurred prenatally (maternal smoking) or postnatally (environmental).
HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for P96.81 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This is an exposure code; document whether exposure occurred prenatally (maternal smoking) or postnatally (environmental)
- •Use this code to track environmental risk factors even if no acute symptoms are present at birth