ICD-10-CM Code First Notes · Chapter 18 · FY 2027 R00-R99

Code First Notes in Chapter 18: Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified ICD-10-CM

A Code First note means the underlying condition named in the note is sequenced before this code. In Chapter 18 (R00-R99), notes printed in the chapter name other codes 36 times, and Code First Notes anywhere in the Tabular List name the chapter’s codes 4 times, covering 3 distinct codes, categories and ranges. Switch views to read the list either way.

✓ From the official FY 2027 ICD-10-CM Tabular ListDefinitions follow the Official Guidelines, Section I.A
36
References in Its Notes
4
References to Its Codes
3
Chapter Codes Named
R00-R99
Chapter 18
Chapter 18

Code First Notes by the code that carries the note

16 of 16 shown
  • R05.4 Cough syncope
    • syncope and collapse (R55)
  • R13.1 Dysphagia applies to 6 codes
    • , if applicable, dysphagia following cerebrovascular disease (I69. with final characters -91)
  • R18.0 Malignant ascites
    • malignant neoplasm of ovary (C56.-)
    • secondary malignant neoplasm of retroperitoneum and peritoneum (C78.6)
  • R23.2 Flushing
    • , if applicable, menopausal and female climacteric states (N95.1)
  • R29.5 Transient paralysis
  • R29.7 National Institutes of Health Stroke Scale (NIHSS) score applies to 43 codes
  • R33.8 Other retention of urine
    • enlarged prostate (N40.1)
  • R35 Polyuria applies to 4 codes
    • enlarged prostate (N40.1)
  • R39.1 Other difficulties with micturition applies to 9 codes
    • enlarged prostate (N40.1)
  • R40.2 Coma applies to 97 codes
    • fracture of skull (S02.-)
    • intracranial injury (S06.-)
  • R41.84 Other specified cognitive deficit applies to 5 codes
  • R47.82 Fluency disorder in conditions classified elsewhere
    • Parkinson's disease (G20.-)
  • R50.81 Fever presenting with conditions classified elsewhere
  • R61 Generalized hyperhidrosis
    • , if applicable, menopausal and female climacteric states (N95.1)
  • R65.1 Systemic inflammatory response syndrome (SIRS) of non-infectious origin applies to 2 codes
  • R65.2 Severe sepsis applies to 2 codes
    • infection following a procedure (T81.4-)
    • infections following infusion, transfusion and therapeutic injection (T80.2-)
    • puerperal sepsis (O85)
    • sepsis following complete or unspecified spontaneous abortion (O03.87)
    • sepsis following ectopic and molar pregnancy (O08.82)
    • sepsis following incomplete spontaneous abortion (O03.37)
    • sepsis following (induced) termination of pregnancy (O04.87)
    • sepsis NOS (A41.9)

The first view lists notes printed in this chapter (a note on a category or block applies to every code beneath it). The second lists codes of this chapter named by Code First Notes anywhere in the Tabular List, including notes in other chapters.

Questions About Code First Notes

What does a Code First note mean?

A Code First note means the underlying condition named in the note is sequenced before the code that carries the note. Under the etiology/manifestation convention, a “code first” note appears at the manifestation code and a “use additional code” note at the etiology code (Section I.A.13). The FY 2027 Tabular List has 810 of them; 600 name other codes, with 736 references to 429 distinct codes, categories and ranges.

Can a code with a Code First note be the principal diagnosis?

Not when it is a manifestation code. Codes titled “in diseases classified elsewhere” are never permitted as the first-listed or principal diagnosis; they must follow the underlying condition. The etiology and manifestation page lists them all.

Related References

ICD-10-CM Official GuidelinesICD-10-CM Code LookupICD-10-CM Codes ListCode Lists by Tag

Source: FY 2027 ICD-10-CM Tabular List (CMS and NCHS) and the ICD-10-CM Official Guidelines for Coding and Reporting FY 2027, Section I.A. ICD List is not affiliated with CMS or NCHS.