2027 ICD-10-CM Diagnosis Code R12Heartburn
ICD-10-CM Codes›R00–R99›R10-R19›R12
- Billable — Valid for Submission
- Not Chronic
R12 is a billable ICD-10-CM diagnosis code for heartburn. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 391 through 392. 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 burning pain. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Abdominal pain and other digestive/abdomen signs and symptoms.
Code Identity
Code Classification
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Burning pain
- Digestive system reflux
- Esophageal reflux finding
- Finding of esophageal function
- Functional heartburn
- Heartburn
- Pain in esophagus
- Waterbrash
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to R12: its own notes plus those printed at block R10-R19 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.
- functional dyspepsia (K30)
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.
- dyspepsia NOS (R10.13)
- congenital or infantile pylorospasm (Q40.0)
- gastrointestinal hemorrhage (K92.0-K92.2)
- intestinal obstruction (K56.-)
- newborn gastrointestinal hemorrhage (P54.0-P54.3)
- newborn intestinal obstruction (P76.-)
- pylorospasm (K31.3)
- signs and symptoms involving the urinary system (R30-R39)
- symptoms referable to female genital organs (N94.-)
- symptoms referable to male genital organs (N48-N50)
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.
Referenced in Other NotesGuidance
Instructional notes printed at other codes that name R12, its category, or a range that includes it.
Applicable To 1
These notes mention R12.
- G71.035 Limb girdle muscular dystrophy due to anoctamin-5 dysfunctionAnoctamin-5-related LGMD R12
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
Brash (water) R12
Heartburn R12
Pyrosis R12
Waterbrash R12
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Clinical InformationClinical
Heartburn
substernal pain or burning sensation, usually associated with regurgitation of gastric juice into the esophagus.
Patient EducationClinical
Heartburn
Heartburn is a painful burning feeling in your chest or throat. It happens when stomach acid backs up into your esophagus, the tube that carries food from your mouth to your stomach.
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert R12 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About R12Overview
What is the ICD-10 code for heartburn?
The ICD-10-CM code for heartburn is R12. It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is R12 (Heartburn) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report heartburn on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does R12 group to?
When heartburn is the principal diagnosis on an inpatient stay, it groups to MS-DRG 392, 391, with relative weights from 0.7645 to 1.2389 depending on complications. Higher weights mean higher Medicare reimbursement.
Can R12 be a principal diagnosis?
Use it with care. This is a symptom code, so once a definitive diagnosis explaining the heartburn is established, that condition takes the principal position instead.
Can R12 be reported with K30?
Not as a rule. The Excludes1 note on R12 lists "functional dyspepsia (K30)". 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).
