R44.1

R44.1: Visual hallucinations

Billable / specific codeICD-10-CM

R44.1 is a billable, specific ICD-10-CM code for visual hallucinations. It is valid for submission on a claim.

Check R44.1 with the rest of the claim: free scrubber

Excludes1 inherited from the categories above R44.1

A category’s note binds every code beneath it.

Written on R44: Other symptoms and signs involving general sensations and perceptions

alcoholic hallucinations (F10.151, F10.251, F10.951)
hallucinations in drug psychosis (F11-F19 with fifth to sixth characters 51)
hallucinations in mood disorders with psychotic symptoms (F30.2, F31.5, F32.3, F33.3)
hallucinations in schizophrenia, schizotypal and delusional disorders (F20-F29)

Excludes2 inherited from the categories above R44.1

Not part of this code, but both may be coded when both are present.

Written on R44: Other symptoms and signs involving general sensations and perceptions

disturbances of skin sensation (R20.-)

Other codes that can never be billed with R44.1

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

H53.1Subjective visual disturbances

Risk adjustment

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

Medicare coverage

R44.1 is named in 9 Medicare coverage policies: 9 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

A53060Billing and Coding: Ophthalmology: Extended Ophthalmoscopy and Fundus Photography
A56505Billing and Coding: Transesophageal Echocardiography (TEE)
A56726Billing and Coding: Ophthalmology: Posterior Segment Imaging (Extended Ophthalmoscopy and Fundus Photography)
A56773Billing and Coding: Neurophysiology Evoked Potentials (NEPs)