2027 ICD-10-CM Diagnosis Code R78.1Finding of opiate drug in blood

ICD-10-CM Codes›R00–R99›R70-R79›R78

ICD-10-CM R78.1
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

R78.1 is a billable ICD-10-CM diagnosis code for finding of opiate drug in blood. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 947 through 948. 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 Abnormal findings related to substance use.

Code Identity

ICD-10-CM Code
R78.1
Billable Status
Yes — Valid for Submission
Code Describes
Finding of opiate drug in blood
Short Description
Finding of opiate drug in blood
Same as the full description in the CMS dataset.
Parent Code
R78
Findings of drugs and other substances, not normally found in blood

Code Classification

ChapterR00–R99Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified
SectionR70-R79Abnormal findings on examination of blood, without diagnosis
CategoryR78Findings of drugs and other substances, not normally found in blood
This CodeR78.1Finding of opiate drug in blood

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to R78.1: its own notes plus those printed at R78, block R70-R79, 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 R78 Findings of drugs and other substances, not normally found in blood applies to 13 codes
  • mental or behavioral disorders due to psychoactive substance use (F10-F19)
From Block R70-R79 Abnormal findings on examination of blood, without diagnosis applies to 45 codes
  • abnormal findings on antenatal screening of mother (O28.-)
  • abnormalities of lipids (E78.-)
  • abnormalities of platelets and thrombocytes (D69.-)
  • abnormalities of white blood cells classified elsewhere (D70-D72)
  • coagulation hemorrhagic disorders (D65-D68)
  • diagnostic abnormal findings classified elsewhere - see Alphabetical Index
  • hemorrhagic and hematological disorders of newborn (P50-P61)
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)

Use Additional Code

Add a second code, after this one, to fully describe the condition.

From R78 Findings of drugs and other substances, not normally found in blood applies to 13 codes
  • code to identify any retained foreign body, if applicable (Z18.-)

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 R78.1, its category, or a range that includes it.

Excludes2 1

These codes carry an Excludes2 note naming R78.1: its condition is not part of those codes, and both may be reported when the patient has both.

  • Block R83-R89 Abnormal findings on examination of other body fluids, substances and tissues, without diagnosis
    abnormal findings on examination of blood, without diagnosis (R70-R79) names R70-R79, which includes this code

Use Additional Code 1

These codes say to use an additional code from the note, and R78.1 is one of the codes named.

  • Z02.83 Encounter for blood-alcohol and blood-drug test
    code for findings of alcohol or drugs in blood (R78.-) names R78.-, 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 SYM009
Abnormal findings related to substance use
Default principal diagnosis: inpatient Yes · outpatient Yes

Convert R78.1 to ICD-9-CMHistory

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

ICD-9-CM
790.99 Oth nspcf finding blood
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 R78.1Overview

What is the ICD-10 code for finding of opiate drug in blood?

The ICD-10-CM code for finding of opiate drug in blood is R78.1 (sometimes written as R781). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

Is R78.1 a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report finding of opiate drug in blood on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

What MS-DRG does R78.1 group to?

When finding of opiate drug in blood is the principal diagnosis on an inpatient stay, it groups to MS-DRG 948, 947, with relative weights from 0.7833 to 1.2608 depending on complications. Higher weights mean higher Medicare reimbursement.

Can R78.1 be a principal diagnosis?

Use it with care. This is a symptom code, so once a definitive diagnosis explaining the finding of opiate drug in blood is established, that condition takes the principal position instead.

Does R78.1 need an additional code?

When the condition applies, yes. The Use Additional Code note at R78, which applies to R78.1, reads: code to identify any retained foreign body, if applicable (Z18.-). The additional code is reported after R78.1.