Is R06.5 a billable ICD-10-CM code?

Yes. R06.5 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does R06.5 sit in the tabular list?

Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99), in the block Symptoms and signs involving the circulatory and respiratory systems (R00-R09).

What cannot be coded together with R06.5?

R06.5 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above R06.5 (R06) and apply to it just the same.

R06.5

R06.5 — Mouth breathing

Billable / specific codeICD-10-CM

R06.5 is a billable, specific ICD-10-CM code for mouth breathing. It is valid for submission on a claim.

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.

dry mouth NOS (R68.2)

Excludes1 inherited from the categories above R06.5

These are not written on R06.5, but they bind it: a note on a category applies to every code beneath it. Billing R06.5 with anything listed here is a denial.

Written on R06 — Abnormalities of breathing

acute respiratory distress syndrome (J80)
respiratory arrest (R09.2)
respiratory arrest of newborn (P28.81)
respiratory distress syndrome of newborn (P22.-)
respiratory failure (J96.-)
respiratory failure of newborn (P28.5)

Risk adjustment

R06.5 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.

Medicare coverage

R06.5 is named in 1 Medicare coverage policy — 1 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A57063Billing and Coding: Diagnostic and Therapeutic Esophagogastroduodenoscopy

How R06.5 is indexed

Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to R06.5.

Snuffles(non-syphilitic)
Breathing›mouth

Code history

R06.5 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Related codes at this level

Codes that share R06. If R06.5 is not quite right, the correct code is usually one of these.

Questions about R06.5

Is R06.5 a billable ICD-10-CM code?: Yes. R06.5 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does R06.5 sit in the tabular list?: Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99), in the block Symptoms and signs involving the circulatory and respiratory systems (R00-R09).
What cannot be coded together with R06.5?: R06.5 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above R06.5 (R06) and apply to it just the same.