Chapter 18: Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified
R00-R99
Chapter 18 of the ICD-10-CM tabular list covers symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified, codes R00-R99. It holds 962 codes across 14 blocks, of which 773 are billable and 189 are header codes that cannot go on a claim. 118 (12%) require a 7th character.
Excludes2 — not included here, but may coexist
The excluded condition is not part of this code, but a patient can have both. You may code both.
Notes
Additional guidance from the ICD-10-CM tabular list.
- This chapter includes symptoms, signs, abnormal results of clinical or other investigative procedures, and ill-defined conditions regarding which no diagnosis classifiable elsewhere is recorded.
- Signs and symptoms that point rather definitely to a given diagnosis have been assigned to a category in other chapters of the classification. In general, categories in this chapter include the less well-defined conditions and symptoms that, without the necessary study of the case to establish a final diagnosis, point perhaps equally to two or more diseases or to two or more systems of the body. Practically all categories in the chapter could be designated 'not otherwise specified', 'unknown etiology' or 'transient'. The Alphabetical Index should be consulted to determine which symptoms and signs are to be allocated here and which to other chapters. The residual subcategories, numbered .8, are generally provided for other relevant symptoms that cannot be allocated elsewhere in the classification.
- The conditions and signs or symptoms included in categories R00-R94 consist of:
- (a) cases for which no more specific diagnosis can be made even after all the facts bearing on the case have been investigated;
- (b) signs or symptoms existing at the time of initial encounter that proved to be transient and whose causes could not be determined;
- (c) provisional diagnosis in a patient who failed to return for further investigation or care;
- (d) cases referred elsewhere for investigation or treatment before the diagnosis was made;
- (e) cases in which a more precise diagnosis was not available for any other reason;
- (f) certain symptoms, for which supplementary information is provided, that represent important problems in medical care in their own right.
Risk adjustment in Chapter 18
60 of this chapter’s codes map to a CMS-HCC, which means the diagnosis carries a risk-adjustment payment when it is documented and coded to the level the record supports.
- HCC 202 Coma, Brain Compression/Anoxic Damage
- HCC 2 Septicemia, Sepsis, Systemic Inflammatory Response Syndrome/Shock
- HCC 201 Seizure Disorders and Convulsions
- HCC 213 Cardio-Respiratory Failure and Shock
- HCC 155 Major Depression, Moderate or Severe, without Psychosis
- HCC 180 Quadriplegia
Blocks in this chapter
- R00-R09Symptoms and signs involving the circulatory and respiratory systems73 codes
- R10-R19Symptoms and signs involving the digestive system and abdomen120 codes
- R20-R23Symptoms and signs involving the skin and subcutaneous tissue31 codes
- R25-R29Symptoms and signs involving the nervous and musculoskeletal systems87 codes
- R30-R39Symptoms and signs involving the genitourinary system54 codes
- R40-R46Symptoms and signs involving cognition, perception, emotional state and behavior192 codes
- R47-R49Symptoms and signs involving speech and voice25 codes
- R50-R69General symptoms and signs88 codes
- R70-R79Abnormal findings on examination of blood, without diagnosis59 codes
- R80-R82Abnormal findings on examination of urine, without diagnosis31 codes
- R83-R89Abnormal findings on examination of other body fluids, substances and tissues, without diagnosis109 codes
- R90-R94Abnormal findings on diagnostic imaging and in function studies, without diagnosis85 codes
- R97Abnormal tumor markers7 codes
- R99Ill-defined and unknown cause of mortality1 code