2027 ICD-10-CM Diagnosis Code R45.88Nonsuicidal self-harm
R45.88 is a billable ICD-10-CM diagnosis code for nonsuicidal self-harm. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 883. As a symptom code, it should not be used as a principal diagnosis once a related definitive diagnosis has been established. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under External cause codes: intent of injury, self-harm; External cause codes: unspecified mechanism; and Other unspecified injury.
For Medicare Advantage risk adjustment, R45.88 maps to CMS-HCC Category 155 (Major Depression, Moderate or Severe, without Psychosis) under the V28 model, adding a risk factor of about 0.299 for a community, non-dual, aged beneficiary in payment year 2027.
Code Identity
Code Classification
Medicare Risk Adjustment (HCC)Billing
R45.88 maps to a payment category in the CMS-HCC model used to risk-adjust Medicare Advantage payments. Weights are the published community factors for payment year 2027.
Source: CMS Payment Year 2027 risk adjustment mappings and model software. Weights are relative factors, not dollar amounts; a beneficiary's total RAF also includes demographics and interactions. Browse all CMS-HCC categories.
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to R45.88: 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.
Applicable To
Conditions this code is used for: synonyms of the title or, for "other specified" codes, the conditions assigned to it. The list is not exhaustive.
- Nonsuicidal self-injury
- Nonsuicidal self-mutilation
- Self-inflicted injury without suicidal intent
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.
Code Also
A second code may be needed to fully describe the condition; the note gives no sequencing direction.
- injury, if known
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 R45.88, its category, or a range that includes it.
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
nonsuicidal R45.88
Self-injury, nonsuicidal R45.88
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Patient EducationClinical
Self-Harm
Self-harm, or self-injury, is when a person hurts his or her own body on purpose. The injuries may be minor, but sometimes they can be severe. They may leave permanent scars or cause serious health problems. Some examples are:
The full article covers:
- What is self-harm?
- Why do people harm themselves?
- Who is at risk for self-harm?
- What are the signs of self-harm?
- How can I help someone who self-harms?
- What are the treatments are for self-harm?
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Code History & ChangesHistory
Replacement R45.88 replaces the following previously assigned code(s):
- R45.89 - Other symptoms and signs involving emotional state
Questions About R45.88Overview
What is the ICD-10 code for nonsuicidal self-harm?
The ICD-10-CM code for nonsuicidal self-harm is R45.88 (sometimes written as R4588). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is R45.88 (Other symptoms and signs involving emotional state) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report nonsuicidal self-harm on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does R45.88 group to?
When nonsuicidal self-harm is the principal diagnosis on an inpatient stay, it groups to MS-DRG 883 (disorders of Personality and Impulse Control), which carries a relative weight of 1.7398. Higher weights mean higher Medicare reimbursement.
Can R45.88 be a principal diagnosis?
Use it with care. This is a symptom code, so once a definitive diagnosis explaining the nonsuicidal self-harm is established, that condition takes the principal position instead.
What HCC is R45.88?
R45.88 (nonsuicidal self-harm) maps to CMS-HCC Category 155 (Major Depression, Moderate or Severe, without Psychosis), commonly written as HCC 155, in the CMS-HCC V28 model used for Medicare Advantage risk adjustment in payment year 2027. It mapped to HCC 59 under the retired V24 model. It also maps in the PACE (CMS-HCC V22), ESRD (V21), and ESRD (V24) models. In the Part D prescription drug model it maps to RxHCC 132.
Does R45.88 risk-adjust for Medicare Advantage payment?
Yes. When documented and reported on a Medicare Advantage encounter, R45.88 adds a risk adjustment factor of about 0.299 to the beneficiary's RAF score for a community, non-dual, aged enrollee (published V28 weights range from 0.108 to 0.316 depending on the payment segment). A more severe related category (HCC 151, HCC 152, HCC 153, and HCC 154) supersedes it when both are reported. See the full factor table on the HCC 155 category page.
