R53.81

R53.81: Other malaise

Billable / specific codeICD-10-CM

R53.81 is a billable, specific ICD-10-CM code for other malaise. It is valid for submission on a claim.

Check R53.81 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.

age-related physical debility (R54)

Inclusion terms

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

Chronic debility
Debility NOS
General physical deterioration
Malaise NOS
Nervous debility

Excludes1 inherited from the categories above R53.81

A category’s note binds every code beneath it.

Written on R53.8: Other malaise and fatigue

combat exhaustion and fatigue (F43.0)
congenital debility (P96.9)
exhaustion and fatigue due to excessive exertion (T73.3)
exhaustion and fatigue due to exposure (T73.2)
exhaustion and fatigue due to heat (T67.-)
exhaustion and fatigue due to pregnancy (O26.8-)
exhaustion and fatigue due to recurrent depressive episode (F33-)
exhaustion and fatigue due to senile debility (R54)

Risk adjustment

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

Medicare coverage

R53.81 is named in 10 Medicare coverage policies: 10 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

A54969Billing and Coding: Nerve Conduction Studies and Electromyography
A56619Billing and Coding: Nerve Conduction Studies and Electromyography
A57122Billing and Coding: Parathormone (Parathyroid Hormone)
A57189Billing and Coding: Serum Magnesium

Alphabetic index entries that lead here

Debility(chronic) (general) (nervous)
Malaise
Debility›nervous
Deterioration›general physical

Code history

Unchanged in every release from FY2024 to FY2027.