R78.9 — Finding of unspecified substance, not normally found in blood
R78.9 is a billable, specific ICD-10-CM code for finding of unspecified substance, not normally found in blood. It is valid for submission on a claim.
Risk adjustment
R78.9 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
R78.9 is named in 1 Medicare coverage policy — 1 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A57063Billing and Coding: Diagnostic and Therapeutic Esophagogastroduodenoscopy
How R78.9 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 R78.9.
- Abnormal, abnormality, abnormalities›toxicology(findings)
- Blood›constituents, abnormal
- Findings, abnormal, inconclusive, without diagnosis›in blood(of substance not normally found in blood)
Related codes at this level
Codes that share R78. If R78.9 is not quite right, the correct code is usually one of these.
- R78.0Finding of alcohol in blood
- R78.1Finding of opiate drug in blood
- R78.2Finding of cocaine in blood
- R78.3Finding of hallucinogen in blood
- R78.4Finding of other drugs of addictive potential in blood
- R78.5Finding of other psychotropic drug in blood
- R78.6Finding of steroid agent in blood
- R78.7Finding of abnormal level of heavy metals in blood
- R78.8Finding of other specified substances, not normally found in blood
Questions about R78.9
- Is R78.9 a billable ICD-10-CM code?
- Yes. R78.9 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does R78.9 sit in the tabular list?
- Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99), in the block Abnormal findings on examination of blood, without diagnosis (R70-R79).