R09.81

R09.81: Nasal congestion

Billable / specific codeICD-10-CM

R09.81 is a billable, specific ICD-10-CM code for nasal congestion. It is valid for submission on a claim.

Check R09.81 with the rest of the claim: free scrubber

Excludes1 inherited from the categories above R09.81

A category’s note binds every code beneath it.

Written on R09: Other symptoms and signs involving the circulatory and respiratory system

acute respiratory distress syndrome (J80)
respiratory arrest of newborn (P28.81)
respiratory distress syndrome of newborn (P22.0)
respiratory failure (J96.-)
respiratory failure of newborn (P28.5)

Risk adjustment

No CMS-HCC V28 category: this code does not change a RAF score.

Medicare coverage

R09.81 is named in 15 Medicare coverage policies: 15 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

A56464Billing and Coding: Flow Cytometry
A56658Billing and Coding: Cosmetic and Reconstructive Surgery
A56729Billing and Coding: Magnetic Resonance Imaging of the Head and Neck
A58774Billing and Coding: Cosmetic and Reconstructive Surgery

Alphabetic index entries that lead here

Congestion, congestive›nasal
Congestion, congestive›nose

Code history

Unchanged in every release from FY2024 to FY2027.