Heartburn
In Symptoms and signs involving the digestive system and abdomen (R10-R19), chapter 18: Symptoms, Signs and Abnormal Clinical and Laboratory Findings
- R12 is billable and valid on claims for FY 2027. If the record has more detail, check the other codes under R10-R19 below.
- As a secondary diagnosis it is not a CC or MCC, so it doesn't raise the MS-DRG payment.
- Doesn't count toward a Medicare Advantage risk score (no HCC in V28).
- AHRQ's Chronic Condition Indicator classes it as not chronic (an acute or short-term condition).
Also indexed as: Brash; Heartburn; Pyrosis; Waterbrash
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Instructional notes
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 R12.
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)
Other codes under R10-R19
Symptoms and signs involving the digestive system and abdomen (R10-R19)
- R10Abdominal and pelvic pain
- R11Nausea and vomiting
- R12Heartburn(this code)
- R13Aphagia and dysphagia
- R14Flatulence and related conditions
- R15Fecal incontinence
- R16Hepatomegaly and splenomegaly, not elsewhere classified
- R17Unspecified jaundice
- R18Ascites
- R19Other symptoms and signs involving the digestive system and abdomen
R12 MS-DRGs
As the principal diagnosis, R12 groups to MS-DRG 391 or 392 (v44.0). Which one applies depends on procedures performed, secondary diagnoses (CC/MCC), and the patient's age and discharge status.
Related conditions
Grouped by AHRQ's Clinical Classifications Software Refined (CCSR), which sorts every diagnosis code into clinically meaningful categories.
R12 is in Abdominal pain and other digestive/abdomen signs and symptoms (SYM006, its default category), with 78 codes. Others in it:
Medicare coverage articles listing R12
These 5 Medicare billing and coding articles list R12 as a diagnosis that supports medical necessity for the services they cover. From the CMS Medicare Coverage Database; check your own contractor's article before billing.
Other codes that refer to R12
Notes on these codes point to R12.
About the condition
Plain-language background from MedlinePlus (National Library of Medicine), not coding guidance.
Heartburn
Heartburn is a painful burning feeling in your chest or throat. It happens when stomach acid backs up into your esophagus, the tube that carries food from your mouth to your stomach.
Read more about heartburn on MedlinePlusCode history
Valid since FY2016, when ICD-10-CM took effect on October 1, 2015. No changes since.
ICD-9-CM equivalent
Legacy crosswalk from the CMS General Equivalence Mappings (last updated 2018).
- 787.1 Heartburn