Is R78.81 a billable ICD-10-CM code?

Yes. R78.81 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does R78.81 sit in the tabular list?

Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99), in the block Abnormal findings on examination of blood, without diagnosis (R70-R79).

What cannot be coded together with R78.81?

R78.81 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.

R78.81

R78.81 — Bacteremia

Billable / specific codeICD-10-CM

R78.81 is a billable, specific ICD-10-CM code for bacteremia. 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.

sepsis-code to specified infection

Other codes that can never be billed with R78.81

These codes carry an Excludes1 note pointing at R78.81. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading R78.81 alone.

A41Other sepsis
A49.9Bacterial infection, unspecified

Risk adjustment

R78.81 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

R78.81 is named in 24 Medicare coverage policies — 24 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A52868Billing and Coding: Transesophageal Echocardiography (TEE)
A56505Billing and Coding: Transesophageal Echocardiography (TEE)
A56625Billing and Coding: Echocardiography
A56625Billing and Coding: Echocardiography

How R78.81 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 R78.81.

Bacteremia
Findings, abnormal, inconclusive, without diagnosis›culture›blood
Positive›culture›blood

Related codes at this level

Codes that share R78.8. If R78.81 is not quite right, the correct code is usually one of these.

R78.89Finding of other specified substances, not normally found in blood

Questions about R78.81

Is R78.81 a billable ICD-10-CM code?: Yes. R78.81 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does R78.81 sit in the tabular list?: Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99), in the block Abnormal findings on examination of blood, without diagnosis (R70-R79).
What cannot be coded together with R78.81?: R78.81 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.