Is ICD-10-CM code R04 billable?

No, R04 (Hemorrhage from respiratory passages) 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 R04 belong to?

R04 belongs to Chapter 18 of the ICD-10-CM tabular list: R00–R99 (Symptoms, Signs and Abnormal Clinical and Laboratory Findings).

R04Not billable, use a more specific code below

Hemorrhage from respiratory passages

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

6 billable codes under R04: 4 are a CC; none map to an HCC.A CC or MCC (major CC) is a secondary diagnosis that raises the MS-DRG payment.

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 R04

R04 can't be used on a claim. Pick a billable code below; grey headings group them.

R04 MS-DRGs

As the principal diagnosis, the billable codes under R04 group to MS-DRG 204, 150, 151, 154, 155, or 156 (v44.0). Which one applies depends on procedures performed, secondary diagnoses (CC/MCC), and the patient's age and discharge status.

DRG 204 Respiratory Signs and Symptoms (4 of 6 codes)
DRG 150 Epistaxis with MCC (1 of 6 codes)
DRG 151 Epistaxis without MCC (1 of 6 codes)
DRG 154 Other Ear, Nose, Mouth and Throat Diagnoses with MCC (1 of 6 codes)
DRG 155 Other Ear, Nose, Mouth and Throat Diagnoses with CC (1 of 6 codes)
DRG 156 Other Ear, Nose, Mouth and Throat Diagnoses without CC/MCC (1 of 6 codes)

About the condition

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

Nose Injuries and Disorders

Your nose is important to your health. It filters the air you breathe, removing dust, germs, and irritants. It warms and moistens the air to keep your lungs and tubes that lead to them from drying out. Your nose also contains the nerve cells that help your sense of smell. When there is a problem with your nose, your whole body can suffer. For example, the stuffy nose of the common cold can make it hard for you to breathe, sleep, or get comfortable.

Code history

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