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 15 ICD-10-CM diagnosis codes. 12 of them are billable and valid for claim submission in fiscal year 2026, 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.
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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 15 codes · 12 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
- R78.79 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.
Hemorrhagic Septicemia
Any of several bacterial diseases, usually caused by PASTEURELLA MULTOCIDA, marked by the presence of hemorrhagic areas in the subcutaneous tissues, serous membranes, muscles, lymph glands, and throughout the internal organs. The diseases primarily affect animals and rarely humans.
Pasteurella multocida
A species of gram-negative, facultatively anaerobic, rod-shaped bacteria normally found in the flora of the mouth and respiratory tract of animals and birds. It causes shipping fever (see PASTEURELLOSIS, PNEUMONIC); HEMORRHAGIC BACTEREMIA; and intestinal disease in animals. In humans, disease usually arises from a wound infection following a bite or scratch from domesticated animals.
About the R78 Code Range
The ICD-10 code section R78 is used to document findings of drugs and other substances that are not normally present in the blood. This includes a variety of specific substances such as alcohol, opiates, cocaine, hallucinogens, and heavy metals, among others.
These codes help healthcare providers and medical coders precisely identify abnormal blood test results. For example, R78.0 corresponds to detection of alcohol in the blood, also known as a "high ethanol level in blood," while R78.71 indicates an abnormal lead level, referred to as "blood lead level above reference range." Codes like R78.81 cover bacteremia, which is the presence of bacteria in the bloodstream identified by blood culture. The section also includes findings of psychotropic drugs, steroids, and various heavy metals. Using the correct ICD-10 code for specific substances ensures accurate documentation of lab findings that are essential for diagnosis and treatment management.
Questions About This Page
How many billable codes are in the R78 range?
Of the 15 codes in this range, 12 are billable and valid for claim submission from October 1, 2025 through September 30, 2026. 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 2026 ICD-10-CM Tabular List and order file, effective October 1, 2025 through September 30, 2026.
