Is ICD-10-CM code R78 billable?

No, R78 (Findings of drugs and other substances, not normally found in blood) 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 R78 belong to?

R78 belongs to Chapter 18 of the ICD-10-CM tabular list: R00–R99 (Symptoms, Signs and Abnormal Clinical and Laboratory Findings).

R78Not billable, use a more specific code below

Findings of drugs and other substances, not normally found in blood

In Abnormal findings on examination of blood, without diagnosis (R70-R79), chapter 18: Symptoms, Signs and Abnormal Clinical and Laboratory Findings

13 billable codes under R78: 1 is a CC; none map to an HCC.A CC or MCC (major CC) is a secondary diagnosis that raises the MS-DRG payment.

Instructional notes

Excludes2: not included here, code separately if applicable

mental or behavioral disorders due to psychoactive substance use (F10-F19)

Use additional code: add a second code for this, listed after this one

code to identify any retained foreign body, if applicable (Z18.-)

Also applies, from Abnormal findings on examination of blood, without diagnosis (R70-R79)

These notes sit on R70-R79 and apply to every code under it, including R78.

Excludes2: not included here, code separately if applicable

abnormal findings on antenatal screening of mother (O28.-)
abnormalities of lipids (E78.-)
abnormalities of platelets and thrombocytes (D69.-)
abnormalities of white blood cells classified elsewhere (D70-D72)
coagulation hemorrhagic disorders (D65-D68)
diagnostic abnormal findings classified elsewhere - see Alphabetical Index
hemorrhagic and hematological disorders of newborn (P50-P61)

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 R78

R78 can't be used on a claim. Pick a billable code below; grey headings group them.

R78 MS-DRGs

As the principal diagnosis, the billable codes under R78 group to these 11 MS-DRGs (v44.0). Which one applies depends on procedures performed, secondary diagnoses (CC/MCC), and the patient's age and discharge status.

DRG 947 Signs and Symptoms with MCC (11 of 13 codes)
DRG 948 Signs and Symptoms without MCC (11 of 13 codes)
DRG 791 Prematurity with Major Problems (1 of 13 codes)
DRG 793 Full Term Neonate with Major Problems (1 of 13 codes)
DRG 870 Septicemia or Severe Sepsis with MV >96 Hours (1 of 13 codes)
DRG 871 Septicemia or Severe Sepsis without MV >96 Hours with MCC (1 of 13 codes)
DRG 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC (1 of 13 codes)
DRG 894 Alcohol, Drug Abuse or Dependence, Left AMA (1 of 13 codes)
DRG 895 Alcohol, Drug Abuse or Dependence with Rehabilitation Therapy (1 of 13 codes)
DRG 896 Alcohol, Drug Abuse or Dependence without Rehabilitation Therapy with MCC (1 of 13 codes)
DRG 897 Alcohol, Drug Abuse or Dependence without Rehabilitation Therapy without MCC (1 of 13 codes)

Other codes that refer to R78

Notes on these codes point to R78.

Z02.83 Use Additional Code: code for findings of alcohol or drugs in blood (R78.-)

About the condition

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

Laboratory Tests

Laboratory tests check a sample of your blood, urine, or body tissues. A technician or your doctor analyzes the test samples to see if your results fall within the normal range. The tests use a range because what is normal differs from person to person. Many factors affect test results. These include:

Code history

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