R60.1
R60.1: Generalized edema
Billable / specific codeICD-10-CM
R60.1 is a billable, specific ICD-10-CM code for generalized edema. It is valid for submission on a claim.
Check R60.1 with the rest of the claim: free scrubberExcludes2: not included here, but may coexist
The excluded condition is not part of this code, but a patient can have both. You may code both.
Excludes1 inherited from the categories above R60.1
A category’s note binds every code beneath it.
Written on R60: Edema, not elsewhere classified
- angioneurotic edema (T78.3)
- ascites (R18.-)
- cerebral edema (G93.6)
- cerebral edema due to birth injury (P11.0)
- edema of larynx (J38.4)
- edema of nasopharynx (J39.2)
- edema of pharynx (J39.2)
- gestational edema (O12.0-)
- hereditary edema (Q82.0)
- hydrops fetalis NOS (P83.2)
- hydrothorax (J94.8)
- newborn edema (P83.3)
- pulmonary edema (J81.-)
Other codes that can never be billed with R60.1
Their own Excludes1 notes name this code, so the conflict is not listed above.
- R22Localized swelling, mass and lump of skin and subcutaneous tissue
Risk adjustment
No CMS-HCC V28 category: this code does not change a RAF score.
Medicare coverage
R60.1 is named in 25 Medicare coverage policies: 25 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A52993Billing and Coding: Peripheral Venous Ultrasound
- A52996Billing and Coding: Routine Foot Care
- A53057Billing and Coding: Home Health Occupational Therapy
- A53064Billing and Coding: Outpatient Occupational Therapy
Alphabetic index entries that lead here
- Anasarca
- Edema, edematous›generalized
Code history
Unchanged in every release from FY2024 to FY2027.