R07.0 — Pain in throat
R07.0 is a billable, specific ICD-10-CM code for pain in throat. It is valid for submission on a claim.
Excludes1 — never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
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.
Excludes1 inherited from the categories above R07.0
These are not written on R07.0, but they bind it: a note on a category applies to every code beneath it. Billing R07.0 with anything listed here is a denial.
Excludes2 inherited from the categories above R07.0
Also inherited, and the opposite of Excludes1: these conditions are not part of R07.0, but a patient can have both, so you may code both.
Other codes that can never be billed with R07.0
These codes carry an Excludes1 note pointing at R07.0. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading R07.0 alone.
- R52Pain, unspecified
Risk adjustment
R07.0 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
R07.0 is named in 3 Medicare coverage policies — 3 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A56729Billing and Coding: Magnetic Resonance Imaging of the Head and Neck
- A57065Billing and Coding: Outpatient Psychiatry and Psychology Services
- A57326Billing and Coding: Electrocardiograms
How R07.0 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 R07.0.
- Pain›laryngeal
- Pain›throat
The condition this code belongs to
Every code for the condition on one page, which one applies when, and the mistake coders make with it.
Code history
R07.0 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 R07. If R07.0 is not quite right, the correct code is usually one of these.
Questions about R07.0
- Is R07.0 a billable ICD-10-CM code?
- Yes. R07.0 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does R07.0 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 R07.0?
- R07.0 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 R07.0 (R07) and apply to it just the same.