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

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

A Use Additional Code note means a second code should be added, after this one, to fully describe the condition. In Chapter 18 (R00-R99), notes printed in the chapter name other codes 25 times, and Use Additional Code Notes anywhere in the Tabular List name the chapter’s codes 61 times, covering 30 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
25
References in Its Notes
61
References to Its Codes
30
Chapter Codes Named
R00-R99
Chapter 18
Chapter 18

Use Additional Code Notes by the code that carries the note

13 of 13 shown
  • R00.1 Bradycardia, unspecified
    • code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5)
  • R33.0 Drug induced retention of urine
    • code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5)
  • R50.2 Drug induced fever
    • code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5)
  • R63.6 Underweight
    • code to identify body mass index (BMI), if known (Z68.-)
  • R65.11 Systemic inflammatory response syndrome (SIRS) of non-infectious origin with acute organ dysfunction
    • acute kidney failure (N17.-)
    • acute respiratory failure (J96.0-)
    • critical illness myopathy (G72.81)
    • critical illness polyneuropathy (G62.81)
    • disseminated intravascular coagulopathy [DIC] (D65)
    • encephalopathy (metabolic) (septic) (G93.41)
    • hepatic failure (K72.0-)
  • R65.2 Severe sepsis applies to 2 codes
    • acute kidney failure (N17.-)
    • acute respiratory failure (J96.0-)
    • critical illness myopathy (G72.81)
    • critical illness polyneuropathy (G62.81)
    • disseminated intravascular coagulopathy [DIC] (D65)
    • encephalopathy (metabolic) (septic) (G93.41)
    • hepatic failure (K72.0-)
  • 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.-)
  • R78.0 Finding of alcohol in blood
    • external cause code (Y90.-), for detail regarding alcohol level.
  • R79 Other abnormal findings of blood chemistry applies to 7 codes
    • code to identify any retained foreign body, if applicable (Z18.-)
  • R82 Other and unspecified abnormal findings in urine applies to 18 codes
    • code to identify any retained foreign body, if applicable (Z18.-)
  • R85.82 Anal low risk human papillomavirus (HPV) DNA test positive
    • code for associated human papillomavirus (B97.7)
  • R87.62 Abnormal cytological findings in specimens from vagina applies to 8 codes
    • code to identify acquired absence of uterus and cervix, if applicable (Z90.71-)
  • R87.82 Low risk human papillomavirus (HPV) DNA test positive from female genital organs applies to 2 codes
    • code for associated human papillomavirus (B97.7)

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 Use Additional Code Notes anywhere in the Tabular List, including notes in other chapters.

Questions About Use Additional Code Notes

What does a Use Additional Code note mean?

A Use Additional Code note tells you to add a second code, reported after the code that carries the note, to describe the condition completely. In an etiology/manifestation pair it sits at the etiology code and points to the manifestation (Section I.A.13). The FY 2027 Tabular List has 1,491 of them; 1,174 name other codes, with 1,438 references to 389 distinct codes, categories and ranges.

Where does the additional code go?

After the code carrying the note. For etiology/manifestation pairs the Guidelines are explicit: the etiology is sequenced first, followed by the manifestation code.

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.