2027 ICD-10-CM Diagnosis Code R05.4Cough syncope

ICD-10-CM Codes›R00–R99›R00-R09›R05

ICD-10-CM R05.4
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

R05.4 is a billable ICD-10-CM diagnosis code for cough syncope. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 204. The code is not accepted as a principal diagnosis by the Medicare Code Editor. As a symptom code, it should not be used as a principal diagnosis once a related definitive diagnosis has been established. Coders also document this condition as situational syncope. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Respiratory signs and symptoms.

Code Identity

ICD-10-CM Code
R05.4
Billable Status
Yes — Valid for Submission
Code Describes
Cough syncope
Short Description
Cough syncope
Same as the full description in the CMS dataset.
Parent Code
R05
Cough

Code Classification

ChapterR00–R99Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified
SectionR00-R09Symptoms and signs involving the circulatory and respiratory systems
CategoryR05Cough
This CodeR05.4Cough syncope

Code EditsBilling

Medicare Code Editor checks that affect claim validity for R05.4.

Unacceptable principal diagnosis
There are selected codes that describe a circumstance which influences an individual's health status but not a current illness or injury, or codes that are not specific manifestations but may be due to an underlying cause. These codes are considered unacceptable as a principal diagnosis.

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Situational syncope
  • Tussive syncope

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to R05.4: its own notes plus those printed at R05 and Chapter 18. A note printed at a category, block or chapter applies to every code under it.

Excludes1

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

From R05 Cough applies to 6 codes
  • paroxysmal cough due to Bordetella pertussis (A37.0-)
  • smoker's cough (J41.0)

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 R05 Cough applies to 6 codes
  • cough with hemorrhage (R04.2)
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)

Code First

The underlying condition named in the note is sequenced before this code.

  • syncope and collapse (R55)

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.

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

Clinical InformationClinical

  • Cough

    a sudden, audible expulsion of air from the lungs through a partially closed glottis, preceded by inhalation. it is a protective response that serves to clear the trachea, bronchi, and/or lungs of irritants and secretions, or to prevent aspiration of foreign materials into the lungs.

Patient EducationClinical

Cough

Coughing is a reflex that keeps your throat and airways clear. Although it can be annoying, coughing helps your body heal or protect itself. Coughs can be either acute or chronic. Acute coughs begin suddenly and usually last no more than 2 to 3 weeks. Acute coughs are the kind you most often get with a cold, flu, or acute bronchitis.

Read the full article at MedlinePlus

Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.

Code History & ChangesHistory

Replacement R05.4 replaces the following previously assigned code(s):

  • R05 - Cough
FY 2022AddedAdded to the ICD-10-CM code setEffective October 1, 2021.
FY 2023–2026No changes
FY 2027CurrentCurrent code set, no changesEffective October 1, 2026 through September 30, 2027.

Questions About R05.4Overview

What is the ICD-10 code for cough syncope?

The ICD-10-CM code for cough syncope is R05.4 (sometimes written as R054). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

Is R05.4 (Cough) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report cough syncope on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

What MS-DRG does R05.4 group to?

On inpatient claims, cough syncope maps to MS-DRG 204 (respiratory Signs and Symptoms), which carries a relative weight of 0.8208. Higher weights mean higher Medicare reimbursement.

Can R05.4 be a principal diagnosis?

No. The Medicare Code Editor rejects this code as a principal diagnosis because cough syncope describes a circumstance that influences health status rather than a current illness. Report it as a secondary diagnosis.

Can R05.4 be reported with a code from A37.0?

Not as a rule. The Excludes1 note at R05, which applies to R05.4, lists "paroxysmal cough due to Bordetella pertussis (A37.0-)". An Excludes1 note means the excluded code is never reported together with this one; the only exception is when the two conditions are unrelated to each other (Official Guidelines, Section I.A.12.a).