2027 ICD-10-CM Diagnosis Code R04.81Acute idiopathic pulmonary hemorrhage in infants

ICD-10-CM Codes›R00–R99›R00-R09›R04

ICD-10-CM R04.81
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

R04.81 is a billable ICD-10-CM diagnosis code for acute idiopathic pulmonary hemorrhage in infants. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 204. As a secondary diagnosis, it counts as a complication or comorbidity (CC) and moves an inpatient stay to a higher severity level within its MS-DRG family. It does not count, however, when the principal diagnosis is one of 6 closely related codes. The code is restricted by the Medicare Code Editor to pediatric patients (age 0 through 17). As a symptom code, it should not be used as a principal diagnosis once a related definitive diagnosis has been established. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Respiratory signs and symptoms.

Code Identity

ICD-10-CM Code
R04.81
Billable Status
Yes — Valid for Submission
Code Describes
Acute idiopathic pulmonary hemorrhage in infants
Short Description
Acute idiopathic pulmonary hemorrhage in infants
Same as the full description in the CMS dataset.
Parent Code
R04.8
Hemorrhage from other sites in respiratory passages

Code Classification

ChapterR00–R99Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified
SectionR00-R09Symptoms and signs involving the circulatory and respiratory systems
CategoryR04Hemorrhage from respiratory passages
This CodeR04.81Acute idiopathic pulmonary hemorrhage in infants

Code EditsBilling

Medicare Code Editor checks that affect claim validity for R04.81.

Pediatric diagnoses
The Medicare Code Editor detects inconsistencies in pediatric cases by checking a patient's age and any diagnosis on the patient's record. The pediatric code edits apply to patients age range is 0–17 years inclusive (e.g., Reye's syndrome, routine child health exam).

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to R04.81: its own notes plus those printed at Chapter 18. A note printed at a category, block or chapter applies to every code under it.

Applicable To

Conditions this code is used for: synonyms of the title or, for "other specified" codes, the conditions assigned to it. The list is not exhaustive.

  • AIPHI
  • Acute idiopathic hemorrhage in infants over 28 days old

Excludes1

Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.

  • perinatal pulmonary hemorrhage (P26.-)
  • von Willebrand disease (D68.0-)

Excludes2

Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.

From Chapter 18 (R00-R99) Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified applies to 774 codes
  • abnormal findings on antenatal screening of mother (O28.-)
  • certain conditions originating in the perinatal period (P04-P96)
  • signs and symptoms classified in the body system chapters
  • signs and symptoms of breast (N63, N64.5)

Notes

General instructions on how these codes are used.

From Chapter 18 (R00-R99) Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified applies to 774 codes
  • This chapter includes symptoms, signs, abnormal results of clinical or other investigative procedures, and ill-defined conditions regarding which no diagnosis classifiable elsewhere is recorded.
  • Signs and symptoms that point rather definitely to a given diagnosis have been assigned to a category in other chapters of the classification. In general, categories in this chapter include the less well-defined conditions and symptoms that, without the necessary study of the case to establish a final diagnosis, point perhaps equally to two or more diseases or to two or more systems of the body. Practically all categories in the chapter could be designated 'not otherwise specified', 'unknown etiology' or 'transient'. The Alphabetical Index should be consulted to determine which symptoms and signs are to be allocated here and which to other chapters. The residual subcategories, numbered .8, are generally provided for other relevant symptoms that cannot be allocated elsewhere in the classification.
  • The conditions and signs or symptoms included in categories R00-R94 consist of:
  • (a) cases for which no more specific diagnosis can be made even after all the facts bearing on the case have been investigated;
  • (b) signs or symptoms existing at the time of initial encounter that proved to be transient and whose causes could not be determined;
  • (c) provisional diagnosis in a patient who failed to return for further investigation or care;
  • (d) cases referred elsewhere for investigation or treatment before the diagnosis was made;
  • (e) cases in which a more precise diagnosis was not available for any other reason;
  • (f) certain symptoms, for which supplementary information is provided, that represent important problems in medical care in their own right.

Source: CMS ICD-10-CM Tabular List. How to read instructional notes.

Referenced in Other NotesGuidance

Instructional notes printed at other codes that name R04.81, its category, or a range that includes it.

Excludes1 2

These codes carry an Excludes1 note naming R04.81: they are not reported together with it, unless the two conditions are unrelated.

  • J84.03 Idiopathic pulmonary hemosiderosis
    acute idiopathic pulmonary hemorrhage in infants [AIPHI] (R04.81)
  • P26 Pulmonary hemorrhage originating in the perinatal period
    acute idiopathic hemorrhage in infants over 28 days old (R04.81)

Index to Diseases and InjuriesGuidance

Alphabetical index entries that point to this code.

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR SYM013
Respiratory signs and symptoms
Default principal diagnosis: inpatient Yes · outpatient Yes

Convert R04.81 to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
786.31 Ac idio pul hemrg infant
Exact Match The mapping is direct, with no qualifiers.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2026No changes
FY 2027CurrentCurrent code set, no changesEffective October 1, 2026 through September 30, 2027.

Questions About R04.81Overview

What is the ICD-10 code for acute idiopathic pulmonary hemorrhage in infants?

The ICD-10-CM code for acute idiopathic pulmonary hemorrhage in infants is R04.81 (sometimes written as R0481). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

Is R04.81 (Hemorrhage from other sites in respiratory passages) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report acute idiopathic pulmonary hemorrhage in infants on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

What MS-DRG does R04.81 group to?

When acute idiopathic pulmonary hemorrhage in infants is the principal diagnosis on an inpatient stay, it groups to MS-DRG 204 (respiratory Signs and Symptoms), which carries a relative weight of 0.8208. Higher weights mean higher Medicare reimbursement.

Is R04.81 a CC or MCC?

CMS lists R04.81 as a CC (complication or comorbidity) for FY 2027. Reported as a secondary diagnosis, it moves the inpatient stay to a higher-weighted DRG within its severity family. It does not count when the principal diagnosis is one of the 6 closely related codes in its exclusion list.

Can R04.81 be a principal diagnosis?

Use it with care. This is a symptom code, so once a definitive diagnosis explaining the acute idiopathic pulmonary hemorrhage in infants is established, that condition takes the principal position instead.