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R07.0

R07.0Pain in throat

Billable / specific codeICD-10-CM

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.

  • chronic sore throat (J31.2)
  • sore throat (acute) NOS (J02.9)

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.

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.

  • Painlaryngeal
  • Painthroat

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 an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.
ICD-10-CMFY2026-Apr· effective April 1, 2026

Loaded directly from the CMS/NCHS ICD-10-CM public-domain release — see data sources and our editorial policy. If this page disagrees with the CMS tabular list, this page is wrong. Reference information for professional coders; not medical or billing advice.