Is ICD-10-CM code R01 billable?

No, R01 (Cardiac murmurs and other cardiac sounds) is a non-billable ICD-10-CM code. It must be coded to a more specific subcategory before it can be used for reimbursement.

What chapter does ICD-10-CM code R01 belong to?

R01 belongs to Chapter 18 of the ICD-10-CM tabular list: R00–R99 (Symptoms, Signs and Abnormal Clinical and Laboratory Findings).

R01Not billable, use a more specific code below

Cardiac murmurs and other cardiac sounds

In Symptoms and signs involving the circulatory and respiratory systems (R00-R09), chapter 18: Symptoms, Signs and Abnormal Clinical and Laboratory Findings

3 billable codes under R01: none are a CC or MCC; none map to an HCC.

Instructional notes

Excludes1: not coded here, use a different code

cardiac murmurs and sounds originating in the perinatal period (P29.8)

Official coding guidelines

From the ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027 (CMS and NCHS). Links open the PDF at the right page.

Covers when to report symptom, sign, and abnormal finding codes (R00-R99), plus specific rules for falls, coma scales, non-infectious SIRS, death NOS, and NIHSS scores.

Use of symptom codes (page 75)
Use of a symptom code with a definitive diagnosis code (page 75)
Combination codes that include symptoms (page 75)
Repeated falls (page 76)
Coma (page 76)
Functional quadriplegia (page 76)
SIRS due to Non-Infectious Process (page 77)
Death NOS (page 77)

Read Section I.C.18 (page 75), 1 more topics

All codes under R01

R01 can't be used on a claim. Pick a billable code below; grey headings group them.

R01 MS-DRGs

As the principal diagnosis, the billable codes under R01 group to MS-DRG 306, 307, 314, 315, or 316 (v44.0). Which one applies depends on procedures performed, secondary diagnoses (CC/MCC), and the patient's age and discharge status.

DRG 306 Cardiac Congenital and Valvular Disorders with MCC (2 of 3 codes)
DRG 307 Cardiac Congenital and Valvular Disorders without MCC (2 of 3 codes)
DRG 314 Other Circulatory System Diagnoses with MCC (1 of 3 codes)
DRG 315 Other Circulatory System Diagnoses with CC (1 of 3 codes)
DRG 316 Other Circulatory System Diagnoses without CC/MCC (1 of 3 codes)

About the condition

Plain-language background from MedlinePlus (National Library of Medicine), not coding guidance.

Congenital Heart Defects

Congenital heart defects (CHDs) are problems with the structure of the heart. "Congenital" means that that the problems are present at birth. These defects happen when a fetus's heart doesn't develop normally during pregnancy. Congenital heart defects are the most common type of birth defect.

Heart Valve Diseases

Heart valve disease happens when one or more of your heart valves don't work well. Your heart has four valves: the tricuspid, pulmonary, mitral, and aortic valves. The valves have flaps that open and close. The flaps make sure that blood flows in the right direction through your heart and to the rest of your body. When your heart beats, the flaps open to let blood through. Between heartbeats they close to stop the blood from flowing backwards.

Code history

Valid since FY2016, when ICD-10-CM took effect on October 1, 2015. No changes since.