2027 ICD-10-CM Diagnosis Code R45.7State of emotional shock and stress, unspecified

ICD-10-CM Codes›R00–R99›R40-R46›R45

ICD-10-CM R45.7
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

R45.7 is a billable ICD-10-CM diagnosis code for state of emotional shock and stress, unspecified. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 880. 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 mental distress. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Symptoms of mental and substance use conditions.

Code Identity

ICD-10-CM Code
R45.7
Billable Status
Yes — Valid for Submission
Code Describes
State of emotional shock and stress, unspecified
Short Description
State of emotional shock and stress, unspecified
Same as the full description in the CMS dataset.
Parent Code
R45
Symptoms and signs involving emotional state

Code Classification

ChapterR00–R99Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified
SectionR40-R46Symptoms and signs involving cognition, perception, emotional state and behavior
CategoryR45Symptoms and signs involving emotional state
This CodeR45.7State of emotional shock and stress, unspecified

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Mental distress

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to R45.7: its own notes plus those printed at block R40-R46 and Chapter 18. A note printed at a category, block or chapter applies to every code under it.

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 Block R40-R46 Symptoms and signs involving cognition, perception, emotional state and behavior applies to 157 codes
  • symptoms and signs constituting part of a pattern of mental disorder (F01-F99)
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 R45.7, its category, or a range that includes it.

Excludes1 1

These codes carry an Excludes1 note naming R45.7: they are not reported together with it, unless the two conditions are unrelated.

  • F07.0 Personality change due to known physiological condition
    signs and symptoms involving emotional state (R45.-) names R45.-, which includes this code

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 SYM008
Symptoms of mental and substance use conditions
Default principal diagnosis: inpatient Yes · outpatient Yes

Patient EducationClinical

Stress

Stress is how your brain and body respond to a challenge or demand. When you are stressed, your body releases certain hormones. Hormones are chemicals that travel in your bloodstream and control how different parts of your body work. The hormones that are released when you are stressed make you alert and ready to act.

The full article covers:

  • What is stress?
  • What causes long-term stress?
  • How can long term-stress harm my health?
  • How can I manage long-term stress?
  • When should I ask my health care provider for help with stress?

Read the full article at MedlinePlus

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

Convert R45.7 to ICD-9-CMHistory

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

ICD-9-CM
308.9 Acute stress react NOS
Approximate The match is approximate rather than exact.

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 R45.7Overview

What is the ICD-10 code for state of emotional shock and stress, unspecified?

The ICD-10-CM code for state of emotional shock and stress, unspecified is R45.7 (sometimes written as R457). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

Is R45.7 (Symptoms and signs involving emotional state) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report state of emotional shock and stress, unspecified on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

What MS-DRG does R45.7 group to?

When state of emotional shock and stress, unspecified is the principal diagnosis on an inpatient stay, it groups to MS-DRG 880 (acute Adjustment Reaction and Psychosocial Dysfunction), which carries a relative weight of 0.9306. Higher weights mean higher Medicare reimbursement.

Can R45.7 be a principal diagnosis?

Use it with care. This is a symptom code, so once a definitive diagnosis explaining the state of emotional shock and stress, unspecified is established, that condition takes the principal position instead.

What is the ICD-9 equivalent of R45.7?

Under the General Equivalence Mappings, state of emotional shock and stress, unspecified converts to ICD-9-CM 308.9 (acute stress react NOS). The mapping is approximate, so confirm the match fits the documentation.