Wiki Newborn affected by maternal drug use diagnosis

[Bernadette10]

Would P04.14 be coded for the below? I was thinking no because there was no positive urine drug screen yet for the newborn and no symptoms. Would I just code Z81.3 family history of substance abuse and dependence unless there are symptoms in the newborn or a positive drug screen? Or is the newborn considered affected whenever the mom had drug use during the pregnancy?

Plan: Buprenorphine exposure - Mom was taking Subutex. Continue Finnegan scoring to assess for drug withdrawal symptoms. So far no symptoms.
Consult social services. Urine negative but does not test for buprenorphine. Meconium pending, and we added buprenorphine to the panel.

What if the mom smoked cigarettes during the pregnancy? Is P04.2 always coded for the newborn?

 

[Bernadette10]

I got an answer on this. If the newborn doesn't have symptoms yet, code the Z05 observation codes for evaluation of suspected conditions ruled out. Don't use the family history code. Only use the P04 codes if the baby has symptoms and is actually affected. The "ruled out" phrase doesn't make sense to me since these babies often develop symptoms later during the same hospital stay when they're born, but since this is profee coding, each date is coded as a separate visit.