Is ICD-10-CM code R09 billable?

No, R09 (Other symptoms and signs involving the circulatory and respiratory system) 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 R09 belong to?

R09 belongs to Chapter 18 of the ICD-10-CM tabular list: R00–R99 (Symptoms, Signs and Abnormal Clinical and Laboratory Findings).

R09Not billable, use a more specific code below

Other symptoms and signs involving the circulatory and respiratory system

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

12 billable codes under R09: 1 is an MCC, 1 is a CC; 1 map to HCC 212 (Respiratory Arrest).A CC or MCC (major CC) is a secondary diagnosis that raises the MS-DRG payment. An HCC counts toward a Medicare Advantage patient's risk score.

Instructional notes

Excludes1: not coded here, use a different code

acute respiratory distress syndrome (J80)
respiratory arrest of newborn (P28.81)
respiratory distress syndrome of newborn (P22.0)
respiratory failure (J96.-)
respiratory failure of newborn (P28.5)

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 R09

R09 can't be used on a claim. Pick a billable code below; grey headings group them.

R09 MS-DRGs

As the principal diagnosis, the billable codes under R09 group to these 15 MS-DRGs (v44.0). Which one applies depends on procedures performed, secondary diagnoses (CC/MCC), and the patient's age and discharge status.

DRG 314 Other Circulatory System Diagnoses with MCC (5 of 12 codes)
DRG 315 Other Circulatory System Diagnoses with CC (5 of 12 codes)
DRG 316 Other Circulatory System Diagnoses without CC/MCC (5 of 12 codes)
DRG 205 Other Respiratory System Diagnoses with MCC (3 of 12 codes)
DRG 206 Other Respiratory System Diagnoses without MCC (3 of 12 codes)
DRG 154 Other Ear, Nose, Mouth and Throat Diagnoses with MCC (2 of 12 codes)
DRG 155 Other Ear, Nose, Mouth and Throat Diagnoses with CC (2 of 12 codes)
DRG 156 Other Ear, Nose, Mouth and Throat Diagnoses without CC/MCC (2 of 12 codes)
DRG 193 Simple Pneumonia and Pleurisy with MCC (1 of 12 codes)
DRG 194 Simple Pneumonia and Pleurisy with CC (1 of 12 codes)
DRG 195 Simple Pneumonia and Pleurisy without CC/MCC (1 of 12 codes)
DRG 204 Respiratory Signs and Symptoms (1 of 12 codes)
DRG 791 Prematurity with Major Problems (1 of 12 codes)
DRG 793 Full Term Neonate with Major Problems (1 of 12 codes)
DRG 795 Normal Newborn (1 of 12 codes)

About the condition

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

Breathing Problems

When you're short of breath, it's hard or uncomfortable for you to take in the oxygen your body needs. You may feel as if you're not getting enough air. Sometimes you can have mild breathing problems because of a stuffy nose or intense exercise. But shortness of breath can also be a sign of a serious disease.

Heart Diseases

Heart disease is a general term that includes many types of heart problems. It's a type of cardiovascular disease, which means heart and blood vessel disease.

Code history

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