R45.5 — Hostility
R45.5 is a billable, specific ICD-10-CM code for hostility. It is valid for submission on a claim.
Risk adjustment
R45.5 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
R45.5 is named in 5 Medicare coverage policies — 4 listing it as supporting medical necessity, and 1 listing it as NOT covered. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A52434Health and Behavior Assessment/Intervention – Medical Policy Articlenot covered
- A56756Billing and Coding: Home Health - Psychiatric Care
- A57130Billing and Coding: Psychiatric Codes
- A57480Billing and Coding: Psychiatry and Psychology Services
How R45.5 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 R45.5.
- Hostility
Related codes at this level
Codes that share R45. If R45.5 is not quite right, the correct code is usually one of these.
Questions about R45.5
- Is R45.5 a billable ICD-10-CM code?
- Yes. R45.5 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does R45.5 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 cognition, perception, emotional state and behavior (R40-R46).