2026 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 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

R05.4 is a billable ICD-10-CM diagnosis code for cough syncope. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026). 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

Tabular List NotesGuidance

Coding notes and annotation back-references applicable to this code.

Code First

  • syncope and collapse R55

Index to Diseases and InjuriesGuidance

Alphabetical index entries that point to this code.

External Cause of Injuries IndexGuidance

References for this code in the External Cause of Injuries Index.

    • Cough(affected) (epidemic) (nervous)
      • syncope
    • Syncope(near) (pre-)
      • laryngeal
    • Vertigo
      • laryngeal

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

  • Antitussive Agents

    agents that suppress cough. they act centrally on the medullary cough center. expectorants, also used in the treatment of cough, act locally.

  • Chronic Cough

    cough lasting for greater than 8 weeks in adults potentially impacting health-related quality of life. chronic cough generally is associated with eosinophilic airway inflammation (e.g., asthma (cough-variant asthma) and non-asthmatic bronchitis, upper airway disorders, gerd and cough hypersensitivity syndrome).

  • 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.

  • Cough-Variant Asthma

    asthma which is characterized by chronic cough that is nonproductive without other asthmatic symptoms, e.g., wheezing, and paroxysmal dyspnea. cough-variant asthma is accompanied by airway hypersensitivity and may progress to classical asthma without treatment.

  • Headache Disorders, Primary

    conditions in which the primary symptom is headache and the headache cannot be attributed to any known causes.

  • Whooping Cough

    a respiratory infection caused by bordetella pertussis and characterized by paroxysmal coughing ending in a prolonged crowing intake of breath.

  • Expectorants

    agents that increase mucous excretion. mucolytic agents, that is drugs that liquefy mucous secretions, are also included here.

  • Headache

    the symptom of pain in the cranial region. it may be an isolated benign occurrence or manifestation of a wide variety of headache disorders.

  • Bordetella pertussis

    a species of gram-negative, aerobic bacteria that is the causative agent of whooping cough. its cells are minute coccobacilli that are surrounded by a slime sheath.

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 2023–2025No changes
FY 2026CurrentCurrent code set, no changesEffective October 1, 2025 through September 30, 2026.

Questions About R05.4Overview

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, 2025 through September 30, 2026.

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.

Footnotes

[1] Not chronic - A diagnosis code that does not fit the criteria for chronic condition (duration, ongoing medical treatment, and limitations) is considered not chronic. Some codes designated as not chronic are acute conditions. Other diagnosis codes that indicate a possible chronic condition, but for which the duration of the illness is not specified in the code description (i.e., we do not know the condition has lasted 12 months or longer) also are considered not chronic.