R52
R52: Pain, unspecified
Billable / specific codeICD-10-CM
R52 is a billable, specific ICD-10-CM code for pain, unspecified. It is valid for submission on a claim.
Check R52 with the rest of the claim: free scrubberExcludes1: never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
- acute and chronic pain, not elsewhere classified (G89.-)
- localized pain, unspecified type - code to pain by site, such as:
- abdomen pain (R10.-)
- back pain (M54.9)
- breast pain (N64.4)
- chest pain (R07.1-R07.9)
- ear pain (H92.0-)
- eye pain (H57.1)
- headache (R51.9)
- joint pain (M25.5-)
- limb pain (M79.6-)
- lumbar region pain (M54.5-)
- pelvic and perineal pain (R10.2-)
- shoulder pain (M25.51-)
- spine pain (M54.-)
- throat pain (R07.0)
- tongue pain (K14.6)
- tooth pain (K08.8)
- renal colic (N23)
- pain disorders exclusively related to psychological factors (F45.41)
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Acute pain NOS
- Generalized pain NOS
- Pain NOS
Other codes that can never be billed with R52
Their own Excludes1 notes name this code, so the conflict is not listed above.
Risk adjustment
No CMS-HCC V28 category: this code does not change a RAF score.
Medicare coverage
R52 is named in 7 Medicare coverage policies: 6 listing it as supporting medical necessity, and 1 listing it as NOT covered. Which one applies depends on your Medicare contractor.
- A57497Billing and Coding: Chest X-Ray Policynot covered
- A56607Billing and Coding: Continuous Peripheral Nerve Blocks (CPNB)
- A57044Billing and Coding: Removal of Benign Skin Lesions
- A57113Billing and Coding: Removal of Benign Skin Lesions
Alphabetic index entries that lead here
- Pain(s)
- Pain›acute
- Pain›generalized NOS
Code history
Unchanged in every release from FY2024 to FY2027.