R42

R42: Dizziness and giddiness

Billable / specific codeICD-10-CM

R42 is a billable, specific ICD-10-CM code for dizziness and giddiness. It is valid for submission on a claim.

Check R42 with the rest of the claim: free scrubber

Excludes1: never code together

These conditions cannot occur together. Billing both on the same encounter is a denial.

vertiginous syndromes (H81.-)
vertigo from infrasound (T75.23)

Inclusion terms

Alternative wordings a physician may use in the chart for this same code.

Light-headedness
Vertigo NOS

Other codes that can never be billed with R42

Their own Excludes1 notes name this code, so the conflict is not listed above.

H81Disorders of vestibular function
R27Other lack of coordination
T75.23XAVertigo from infrasound, initial encounter
T75.23XDVertigo from infrasound, subsequent encounter
T75.23XSVertigo from infrasound, sequela
T75.23Vertigo from infrasound

Risk adjustment

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

Medicare coverage

R42 is named in 26 Medicare coverage policies: 26 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

A53057Billing and Coding: Home Health Occupational Therapy
A53058Billing and Coding: Home Health Physical Therapy
A53064Billing and Coding: Outpatient Occupational Therapy
A53065Billing and Coding: Outpatient Physical Therapy

Alphabetic index entries that lead here

Dizziness
Dysequilibrium
Giddiness
Swimming in the head
Vertigo
Disturbance›equilibrium
Light›headedness
Syndrome›Mal de Debarquement

Code history

Unchanged in every release from FY2024 to FY2027.