Is ICD-10-CM code R11 billable?

No, R11 (Nausea and vomiting) 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 R11 belong to?

R11 belongs to Chapter 18 of the ICD-10-CM tabular list: R00–R99 (Symptoms, Signs and Abnormal Clinical and Laboratory Findings).

R11Not billable, use a more specific code below

Nausea and vomiting

In Symptoms and signs involving the digestive system and abdomen (R10-R19), chapter 18: Symptoms, Signs and Abnormal Clinical and Laboratory Findings

9 billable codes under R11: none are a CC or MCC; 1 map to HCC 137 (Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications).An HCC counts toward a Medicare Advantage patient's risk score.

Instructional notes

Excludes1: not coded here, use a different code

cyclical vomiting associated with migraine (G43.A-)
excessive vomiting in pregnancy (O21.-)
hematemesis (K92.0)
neonatal hematemesis (P54.0)
newborn vomiting (P92.0-)
psychogenic vomiting (F50.89)
vomiting associated with bulimia nervosa (F50.2-)
vomiting following gastrointestinal surgery (K91.0)

Also applies, from Symptoms and signs involving the digestive system and abdomen (R10-R19)

These notes sit on R10-R19 and apply to every code under it, including R11.

Excludes2: not included here, code separately if applicable

congenital or infantile pylorospasm (Q40.0)
gastrointestinal hemorrhage (K92.0-K92.2)
intestinal obstruction (K56.-)
newborn gastrointestinal hemorrhage (P54.0-P54.3)
newborn intestinal obstruction (P76.-)
pylorospasm (K31.3)
signs and symptoms involving the urinary system (R30-R39)
symptoms referable to female genital organs (N94.-)
symptoms referable to male genital organs (N48-N50)

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 R11

R11 can't be used on a claim. Pick a billable code below; grey headings group them.

R11 MS-DRGs

As the principal diagnosis, the billable codes under R11 group to MS-DRG 391, 392, 393, 394, or 395 (v44.0). Which one applies depends on procedures performed, secondary diagnoses (CC/MCC), and the patient's age and discharge status.

DRG 391 Esophagitis, Gastroenteritis and Miscellaneous Digestive Disorders with MCC (7 of 9 codes)
DRG 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive Disorders without MCC (7 of 9 codes)
DRG 393 Other Digestive System Diagnoses with MCC (2 of 9 codes)
DRG 394 Other Digestive System Diagnoses with CC (2 of 9 codes)
DRG 395 Other Digestive System Diagnoses without CC/MCC (2 of 9 codes)

Other codes that refer to R11

Notes on these codes point to R11.

P92.0 Excludes1: vomiting of child over 28 days old (R11.-)

About the condition

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

Nausea and Vomiting

Nausea is when you feel sick to your stomach, as if you are going to throw up. Vomiting is when you throw up. Nausea and vomiting can be symptoms of many different conditions, including:

Code history

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