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ICD-10-CM 2027 diagnosis code

R09.81Nasal congestion

✓ Billable / specific

R09.81 is a valid, billable ICD-10-CM code for nasal congestion. It can be reported on claims for dates of service from October 1, 2026 – September 30, 2027.

Code unchanged since ICD-10-CM took effect on October 1, 2015. Source: official FY2027 ICD-10-CM release from CDC/NCHS and CMS. Page updated September 29, 2026. About our data

About R09.81

R09.81 is the ICD-10-CM diagnosis code for nasal congestion. It belongs to category R09 (other symptoms and signs involving the circulatory and respiratory system), block R00-R09 (symptoms and signs involving the circulatory and respiratory systems) and chapter 18 (symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified). It is billable, so it can be reported on its own for dates of service from October 1, 2026 through September 30, 2027.

Within R09.8 (other specified symptoms and signs involving the circulatory and respiratory systems), R09.81 is specifically for nasal congestion. Related codes cover Postnasal drip (R09.82) and other specified symptoms and signs involving the circulatory and respiratory systems (R09.89).

It is not a CC or MCC, so as a secondary diagnosis it doesn't change the MS-DRG severity level.

In MS-DRG v44.0, it is part of the grouping logic for DRG 154 (Other Ear, Nose, Mouth and Throat Diagnoses with MCC, relative weight 1.5921), DRG 155 (Other Ear, Nose, Mouth and Throat Diagnoses with CC, relative weight 0.9322), DRG 156 (Other Ear, Nose, Mouth and Throat Diagnoses without CC/MCC, relative weight 0.6659) and DRG 795 (Normal Newborn, relative weight 0.2022), in MDC 03 (Diseases and Disorders of the Ear, Nose, Mouth and Throat) and MDC 15 (Newborns and Other Neonates with Conditions Originating in the Perinatal Period), as a principal or secondary diagnosis. The DRG a claim lands in depends on the principal diagnosis, procedures and any CC/MCC secondary diagnoses.

It has been part of ICD-10-CM since the code set took effect on October 1, 2015 and hasn't changed since.

Before ICD-10, this condition was coded in ICD-9-CM as 478.19 (other disease of nasal cavity and sinuses).

Notes that apply from higher levels

Instructions written at a parent level also apply to R09.81.

› From R09 Other symptoms and signs involving the circulatory and respiratory system
Excludes1
  • acute respiratory distress syndrome (J80)
  • respiratory arrest of newborn (P28.81)
  • respiratory distress syndrome of newborn (P22.0)
  • respiratory failure (J96.-)
  • respiratory failure of newborn (P28.5)

Broader instructions also apply from Chapter 18: Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified.

Alphabetic index entries

2 entries

Terms in the official ICD-10-CM index that lead to R09.81.

MS-DRG v44.0 grouping

All DRGs →

Inpatient MS-DRGs this diagnosis can group to, as the principal or a secondary diagnosis, depending on the rest of the claim.

MDC 15 · Newborns and Other Neonates with Conditions Originating in the Perinatal Period

ICD-9-CM equivalent

Converter →
  • 478.19Other disease of nasal cavity and sinusesapproximate

From the CMS 2018 General Equivalence Mappings (GEMs), the final GEMs release.

Code history

  1. 2016
  2. 2017
  3. 2018
  4. 2019
  5. 2020
  6. 2021
  7. 2022
  8. 2023
  9. 2024
  10. 2025
  11. 2026
  12. 2027
  • FY2016 (effective 10/1/2015): Added (first year of ICD-10-CM)
  • No changes since FY2016.

Common questions about R09.81

Is R09.81 billable?

Yes. R09.81 is a billable/specific ICD-10-CM code valid for FY2027 (October 1, 2026 – September 30, 2027).

Can R09.81 be used as a principal diagnosis?

Yes. The Medicare Code Editor doesn't restrict R09.81 as a principal diagnosis.

Is R09.81 a CC or MCC?

No. R09.81 is neither a CC nor an MCC under MS-DRG v44.0.

What DRG does R09.81 group to?

R09.81 is used in the MS-DRG v44.0 logic for MS-DRG 154 (Other Ear, Nose, Mouth and Throat Diagnoses with MCC), MS-DRG 155 (Other Ear, Nose, Mouth and Throat Diagnoses with CC), MS-DRG 156 (Other Ear, Nose, Mouth and Throat Diagnoses without CC/MCC) and MS-DRG 795 (Normal Newborn). Which one applies depends on whether it is the principal diagnosis and on the rest of the claim.

What is the ICD-9 code for R09.81?

The CMS General Equivalence Mappings map R09.81 to ICD-9-CM 478.19.