Findings of drugs and other substances, not normally found in blood (R78) ICD-10-CM
The R78 code range covers findings of drugs and other substances, not normally found in blood with 16 ICD-10-CM diagnosis codes. 13 of them are billable and valid for claim submission in fiscal year 2027, and the category headers group them but cannot themselves be billed.
Use Additional Code
The “use additional code” indicates that a secondary code could be used to further specify the patient’s condition. This note is not mandatory and is only used if enough information is available to assign an additional code.
- code to identify any retained foreign body, if applicable Z18
Type 2 Excludes
A type 2 excludes note represents "Not included here". An excludes2 note indicates that the condition excluded is not part of the condition represented by the code, but a patient may have both conditions at the same time. When an Excludes2 note appears under a code, it is acceptable to use both the code and the excluded code together, when appropriate.
Codes in the R78 Range 16 codes · 13 billable
- R78 Findings of drugs and other substances, not normally found in bloodNon-billable
- R78.0 Finding of alcohol in blood
- R78.1 Finding of opiate drug in blood
- R78.2 Finding of cocaine in blood
- R78.3 Finding of hallucinogen in blood
- R78.4 Finding of other drugs of addictive potential in blood
- R78.5 Finding of other psychotropic drug in blood
- R78.6 Finding of steroid agent in blood
- R78.7 Finding of abnormal level of heavy metals in bloodNon-billable
- R78.71 Abnormal lead level in blood
- R78.72 Abnormal gadolinium level in blood New
- R78.79 Finding of abnormal level of heavy metals in blood
- R78.8 Finding of other specified substances, not normally found in bloodNon-billable
- R78.81 Bacteremia
- R78.89 Finding of other specified substances, not normally found in blood
- R78.9 Finding of unspecified substance, not normally found in blood
Clinical Terms in This Code Range
Definitions from the National Library of Medicine for conditions coded in the R78 range.
Bacteremia
The presence of viable bacteria circulating in the blood. Fever, chills, tachycardia, and tachypnea are common acute manifestations of bacteremia. The majority of cases are seen in already hospitalized patients, most of whom have underlying diseases or procedures which render their bloodstreams susceptible to invasion.
About the R78 Code Range
These findings identify drugs or other substances not normally found in blood, or an abnormal level of heavy metals in blood. They sit among abnormal blood findings without a diagnosis.
R78 separates alcohol, specific drugs, steroid agents, heavy metals, and other substances. Its drug subdivisions distinguish opiates, cocaine, hallucinogens, and other drug types. The heavy-metal branch separates lead, gadolinium, and other heavy metals. Other subdivisions distinguish specified substances from an unspecified substance. R78.81 lists bacteremia, or bacteria in the blood.
FY 2027 changes: The FY 2027 ICD-10-CM update, effective October 1, 2026, added R78.72.
Questions About This Page
How many billable codes are in the R78 range?
Of the 16 codes in this range, 13 are billable and valid for claim submission from October 1, 2026 through September 30, 2027. Category header codes group them but cannot be reported on claims.
What does the R78 range classify?
The range classifies findings of drugs and other substances, not normally found in blood. Each code links to its own reference page with billing status, MS-DRG grouping, coding notes, and clinical information.
Related References
Source: CMS FY 2027 ICD-10-CM Tabular List and order file, effective October 1, 2026 through September 30, 2027.
