2027 ICD-10-CM Diagnosis Code R09.81Nasal congestion
ICD-10-CM Codes›R00–R99›R00-R09›R09
- Billable — Valid for Submission
- Not Chronic
R09.81 is a billable ICD-10-CM diagnosis code for nasal congestion. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 154 through 156, 795. 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 congestion of nasal sinus. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Respiratory signs and symptoms.
Code Identity
Code Classification
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Congestion of nasal sinus
- Nasal congestion
- Respiratory tract congestion
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to R09.81: its own notes plus those printed at R09 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.
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.
Notes
General instructions on how these codes are used.
- 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.
Clinical InformationClinical
Nasal Congestion
the blockage of the nasal passage due to mucosal edema. it is usually the result of a viral infection or an allergic reaction.
Patient EducationClinical
Nose Injuries and Disorders
Your nose is important to your health. It filters the air you breathe, removing dust, germs, and irritants. It warms and moistens the air to keep your lungs and tubes that lead to them from drying out. Your nose also contains the nerve cells that help your sense of smell.
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert R09.81 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About R09.81Overview
What is the ICD-10 code for nasal congestion?
The ICD-10-CM code for nasal congestion is R09.81 (sometimes written as R0981). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is R09.81 a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report nasal congestion on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does R09.81 group to?
When nasal congestion is the principal diagnosis on an inpatient stay, it groups to MS-DRG 156, 795, 155, 154, with relative weights from 0.2022 to 1.5916 depending on complications. Higher weights mean higher Medicare reimbursement.
Can R09.81 be a principal diagnosis?
Use it with care. This is a symptom code, so once a definitive diagnosis explaining the nasal congestion is established, that condition takes the principal position instead.
Can R09.81 be reported with J80?
Not as a rule. The Excludes1 note at R09, which applies to R09.81, lists "acute respiratory distress syndrome (J80)". 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).
