Is ICD-10-CM code R57 billable?

No, R57 (Shock, not elsewhere classified) 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 R57 belong to?

R57 belongs to Chapter 18 of the ICD-10-CM tabular list: R00–R99 (Symptoms, Signs and Abnormal Clinical and Laboratory Findings).

R57Not billable, use a more specific code below

Shock, not elsewhere classified

In General symptoms and signs (R50-R69), chapter 18: Symptoms, Signs and Abnormal Clinical and Laboratory Findings

4 billable codes under R57: 3 are an MCC, 1 is a CC; all map to HCC 2 (Septicemia, Sepsis, Systemic Inflammatory Response Syndrome/Shock), HCC 213 (Cardio-Respiratory Failure and Shock).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

anaphylactic shock NOS (T78.2)
anaphylactic reaction or shock due to adverse food reaction (T78.0-)
anaphylactic shock due to adverse effect of correct drug or medicament properly administered (T88.6)
anaphylactic shock due to serum (T80.5-)
electric shock (T75.4)
obstetric shock (O75.1)
postprocedural shock (T81.1-)
psychic shock (F43.0)
shock complicating or following ectopic or molar pregnancy (O00-O07, O08.3)
shock due to anesthesia (T88.2)
shock due to lightning (T75.01)
traumatic shock (T79.4)
toxic shock syndrome (A48.3)

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 R57

R57 can't be used on a claim. Pick a billable code below; grey headings group them.

R57 MS-DRGs

As the principal diagnosis, the billable codes under R57 group to these 8 MS-DRGs (v44.0). Which one applies depends on procedures performed, secondary diagnoses (CC/MCC), and the patient's age and discharge status.

DRG 291 Heart Failure and Shock with MCC (2 of 4 codes)
DRG 292 Heart Failure and Shock with CC (2 of 4 codes)
DRG 293 Heart Failure and Shock without CC/MCC (2 of 4 codes)
DRG 870 Septicemia or Severe Sepsis with MV >96 Hours (2 of 4 codes)
DRG 871 Septicemia or Severe Sepsis without MV >96 Hours with MCC (2 of 4 codes)
DRG 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC (2 of 4 codes)
DRG 791 Prematurity with Major Problems (1 of 4 codes)
DRG 793 Full Term Neonate with Major Problems (1 of 4 codes)

Other codes that refer to R57

Notes on these codes point to R57.

G90.81 Use Additional Code: shock, not elsewhere classified (R57.-)
T79.4 Excludes1: nontraumatic shock NEC (R57.-)

About the condition

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

Shock

Shock happens when not enough blood and oxygen can get to your organs and tissues. It causes very low blood pressure and may be life-threatening. It often happens along with a serious injury.

Code history

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