R50-R69 — General symptoms and signs
ICD-10-CM codes R50-R69 cover general symptoms and signs, within symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified. The block holds 88 codes across 18 categories, of which 68 are billable and 20 are header codes that cannot be submitted on a claim.
Risk adjustment in R50-R69
0 codes in this block map to a CMS-HCC, which means the diagnosis carries a risk-adjustment payment when it is documented and coded. Under-coding here is money left on the table; over-coding here is what audits are for.
- HCC 2 Septicemia, Sepsis, Systemic Inflammatory Response Syndrome/Shock
- HCC 201 Seizure Disorders and Convulsions
- HCC 213 Cardio-Respiratory Failure and Shock
- HCC 180 Quadriplegia
What else to watch in R50-R69
- 56 codes are named in Medicare coverage policies. An LCD or NCD lists them as supporting medical necessity, or explicitly as not supporting it. Which applies depends on the MAC for your state.
Categories in R50-R69
- R50Fever of other and unknown origin
- R51Headache
- R52Pain, unspecified
- R53Malaise and fatigue
- R54Age-related physical debility
- R55Syncope and collapse
- R56Convulsions, not elsewhere classified
- R57Shock, not elsewhere classified
- R58Hemorrhage, not elsewhere classified
- R59Enlarged lymph nodes
- R60Edema, not elsewhere classified
- R61Generalized hyperhidrosis
- R62Lack of expected normal physiological development in childhood and adults
- R63Symptoms and signs concerning food and fluid intake
- R64Cachexia
- R65Symptoms and signs specifically associated with systemic inflammation and infection
- R68Other general symptoms and signs
- R69Illness, unspecified