2026 ICD-10-CM Diagnosis Code R49.21Hypernasality

ICD-10-CM Codes›R00–R99›R47-R49›R49

ICD-10-CM R49.21
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

R49.21 is a billable ICD-10-CM diagnosis code for hypernasality. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 154 through 156. 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 Other general signs and symptoms.

Code Identity

ICD-10-CM Code
R49.21
Billable Status
Yes — Valid for Submission
Code Describes
Hypernasality
Short Description
Hypernasality
Same as the full description in the CMS dataset.
Parent Code
R49.2
Hypernasality and hyponasality

Code Classification

ChapterR00–R99Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified
SectionR47-R49Symptoms and signs involving speech and voice
CategoryR49Voice and resonance disorders
This CodeR49.21Hypernasality

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Finding of resonance of voice
  • Hypernasal voice
  • Hypernasality and hyponasality
  • Hypernasality of vowels and voiced consonants
  • Hypernasality syndrome
  • Hypernasality syndrome due to neurologic disease
  • Hypernasality syndrome due to velopharyngeal incoordination
  • Hypernasality syndrome due to velopharyngeal weakness
  • Nasal resonatory disorder
  • Nasal voice

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.

    • Hypernasality

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR SYM016
Other general signs and symptoms
Default principal diagnosis: inpatient Yes · outpatient Yes

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 R49.21 to ICD-9-CMHistory

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

ICD-9-CM
784.43 Hypernasality
Exact Match The mapping is direct, with no qualifiers.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2025No changes
FY 2026CurrentCurrent code set, no changesEffective October 1, 2025 through September 30, 2026.

Questions About R49.21Overview

Is R49.21 (Hypernasality and hyponasality) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report hypernasality on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

What MS-DRG does R49.21 group to?

When hypernasality is the principal diagnosis on an inpatient stay, it groups to MS-DRG 154, 155, 156, with relative weights from 0.6911 to 1.5635 depending on complications. Higher weights mean higher Medicare reimbursement.

Can R49.21 be a principal diagnosis?

Use it with care. This is a symptom code, so once a definitive diagnosis explaining the hypernasality is established, that condition takes the principal position instead.

What is the ICD-9 equivalent of R49.21?

Under the General Equivalence Mappings, hypernasality converts to ICD-9-CM 784.43 (hypernasality). The mapping is a direct match.

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.