Is ICD-10-CM code R45 billable?

No, R45 (Symptoms and signs involving emotional state) 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 R45 belong to?

R45 belongs to Chapter 18 of the ICD-10-CM tabular list: R00–R99 (Symptoms, Signs and Abnormal Clinical and Laboratory Findings).

R45Not billable, use a more specific code below

Symptoms and signs involving emotional state

In Symptoms and signs involving cognition, perception, emotional state and behavior (R40-R46), chapter 18: Symptoms, Signs and Abnormal Clinical and Laboratory Findings

18 billable codes under R45: 1 is a CC; 1 map to HCC 155 (Major Depression, Moderate or Severe, without Psychosis).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

Also applies, from Symptoms and signs involving cognition, perception, emotional state and behavior (R40-R46)

These notes sit on R40-R46 and apply to every code under it, including R45.

Excludes2: not included here, code separately if applicable

symptoms and signs constituting part of a pattern of mental disorder (F01-F99)

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

R45 MS-DRGs

As the principal diagnosis, the billable codes under R45 group to these 7 MS-DRGs (v44.0). Which one applies depends on procedures performed, secondary diagnoses (CC/MCC), and the patient's age and discharge status.

DRG 880 Acute Adjustment Reaction and Psychosocial Dysfunction (9 of 18 codes)
DRG 884 Organic Disturbances and Intellectual Disability (3 of 18 codes)
DRG 883 Disorders of Personality and Impulse Control (2 of 18 codes)
DRG 947 Signs and Symptoms with MCC (2 of 18 codes)
DRG 948 Signs and Symptoms without MCC (2 of 18 codes)
DRG 882 Neuroses Except Depressive (1 of 18 codes)
DRG 951 Other Factors Influencing Health Status (1 of 18 codes)

Other codes that refer to R45

Notes on these codes point to R45.

F07.0 Excludes1: signs and symptoms involving emotional state (R45.-)

Code history

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