R06.5 — Mouth breathing
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)
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
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).