R64 — Cachexia
R64 is a billable, specific ICD-10-CM code for cachexia. It is valid for submission on a claim.
Other codes that can never be billed with R64
These codes carry an Excludes1 note pointing at R64. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading R64 alone.
- E88.AWasting disease (syndrome) due to underlying condition
Risk adjustment
R64 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
R64 is named in 5 Medicare coverage policies — 5 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A56421Billing and Coding: CT of the Abdomen and Pelvis
- A56679Billing and Coding: Hospice The Adult Failure To Thrive Syndrome
- A57063Billing and Coding: Diagnostic and Therapeutic Esophagogastroduodenoscopy
- A57189Billing and Coding: Serum Magnesium
How R64 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 R64.
- Cachexia
- Emaciation
- Inanition
- Cachexia›cancerous
- Cachexia›malignant
- Cachexia›pulmonary
Questions about R64
- Is R64 a billable ICD-10-CM code?
- Yes. R64 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does R64 sit in the tabular list?
- Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99), in the block General symptoms and signs (R50-R69).
- What cannot be coded together with R64?
- R64 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.