R55
R55: Syncope and collapse
Billable / specific codeICD-10-CM
R55 is a billable, specific ICD-10-CM code for syncope and collapse. It is valid for submission on a claim.
Check R55 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.
- cardiogenic shock (R57.0)
- carotid sinus syncope (G90.01)
- heat syncope (T67.1)
- neurocirculatory asthenia (F45.8)
- neurogenic orthostatic hypotension (G90.3)
- orthostatic hypotension (I95.1)
- postprocedural shock (T81.1-)
- psychogenic syncope (F48.8)
- shock NOS (R57.9)
- shock complicating or following abortion or ectopic or molar pregnancy (O00-O07, O08.3)
- shock complicating or following labor and delivery (O75.1)
- Stokes-Adams attack (I45.9)
- unconsciousness NOS (R40.2-)
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Blackout
- Fainting
- Vasovagal attack
Risk adjustment
No CMS-HCC V28 category: this code does not change a RAF score.
Medicare coverage
R55 is named in 43 Medicare coverage policies: 43 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A52992Billing and Coding: Non-Invasive Cerebrovascular Arterial Studies
- A54954Billing and Coding: Autonomic Function Tests
- A56423Billing and Coding: Cardiology Non-emergent Outpatient Stress Testing
- A56476Billing and Coding: Cardiac Radionuclide Imaging
Alphabetic index entries that lead here
- Blackout
- Collapse
- Fainting(fit)
- Near-syncope
- Pre-syncope
- Syncope(near) (pre-)
- Vasovagal attack(paroxysmal)
- Arrhythmia›vagal
- Attack, attacks›drop NEC
- Attack, attacks›syncope
- Attack, attacks›unconsciousness
- Attack, attacks›vasomotor
Code history
Unchanged in every release from FY2024 to FY2027.