R11.15 — Cyclical vomiting syndrome unrelated to migraine
R11.15 is a billable, specific ICD-10-CM code for cyclical vomiting syndrome unrelated to migraine. It is valid for submission on a claim.
Excludes1 — never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
- cyclical vomiting in migraine (G43.A-)
Excludes2 — not included here, but may coexist
The excluded condition is not part of this code, but a patient can have both. You may code both.
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Cyclic vomiting syndrome NOS
- Persistent vomiting
Other codes that can never be billed with R11.15
These codes carry an Excludes1 note pointing at R11.15. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading R11.15 alone.
- G43.ACyclical vomiting
Risk adjustment
R11.15 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.
Medicare coverage
R11.15 is named in 10 Medicare coverage policies — 10 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A56389Billing and Coding: Upper Gastrointestinal Endoscopy and Visualization
- A56421Billing and Coding: CT of the Abdomen and Pelvis
- A56456Billing and Coding: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy
- A56767Billing and Coding: Heavy Metal Testing
How R11.15 is indexed
Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to R11.15.
- Vomiting›cyclical syndrome NOS(unrelated to migraine)
- Vomiting›persistent
Related codes at this level
Codes that share R11.1. If R11.15 is not quite right, the correct code is usually one of these.
Questions about R11.15
- Is R11.15 a billable ICD-10-CM code?
- Yes. R11.15 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does R11.15 sit in the tabular list?
- Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99), in the block Symptoms and signs involving the digestive system and abdomen (R10-R19).
- What cannot be coded together with R11.15?
- R11.15 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.