Chapter XVIII
Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified
(R00-R99)

Rules Conventions GCS DChS.XVIII.1 DCS.XIX.8

General symptoms and signs
(R50-R69)

R50 Fever of other and unknown origin

Excl.:
fever of unknown origin (during)(in):
puerperal pyrexia NOS ( O86.4)
R50.2 Drug-induced fever
Coding-Hint
Use additional external cause code (Chapter XX), if desired, to identify drug.
R50.8 Other specified fever
Incl.:
Fever with chills
Fever with rigors
Persistent fever
R50.9 Fever, unspecified
Incl.:
Hyperpyrexia NOS
Pyrexia NOS
Excl.:
malignant hyperthermia due to anaesthesia ( T88.3)

R51 Headache

Incl.:
Facial pain NOS
Excl.:
atypical facial pain ( G50.1)
migraine and other headache syndromes ( G43-G44)
trigeminal neuralgia ( G50.0)

R52 Pain, not elsewhere classified

Incl.:
pain not referable to any one organ or body region
Excl.:
chronic pain personality syndrome ( F62.8)
headache ( R51)
pain (in):
renal colic ( N23)
R52.0 Acute pain
R52.1 Chronic intractable pain
DCS.XVIII.5
R52.2 Other chronic pain
R52.9 Pain, unspecified
Incl.:
Generalized pain NOS

R53 Malaise and fatigue

Incl.:
Asthenia NOS
Debility:
  • NOS
  • chronic
General physical deterioration
Lethargy
Tiredness
Excl.:
debility:
exhaustion and fatigue (due to)(in):
fatigue syndrome ( F48.0)
fatigue syndrome

R54 Senility
DCS.XVIII.6

Incl.:
  • Old age
  • Senescence
  • without mention of psychosis
Senile:
  • asthenia
  • debility
Excl.:
senile psychosis ( F03)

R55 Syncope and collapse

Incl.:
Blackout
Fainting
Excl.:
neurocirculatory asthenia ( F45.3)
orthostatic hypotension ( I95.1)
neurogenic orthostatic hypotension ( G23.8)
shock:
  • NOS (R57.9)
  • cardiogenic (R57.0)
  • complicating or following:
    • —  abortion or ectopic or molar pregnancy (O00-O07, O08.3)
    • —  labour and delivery (O75.1)
  • postoperative (T81.1)
Stokes-Adams attack ( I45.9)
syncope:
unconsciousness NOS ( R40.2)

R56 Convulsions, not elsewhere classified

Excl.:
convulsions and seizures (in):
R56.0 Febrile convulsions
R56.8 Other and unspecified convulsions
Incl.:
Fit NOS
Seizure (convulsive) NOS

R57 Shock, not elsewhere classified

Excl.:
shock (due to):
toxic shock syndrome ( A48.3)
R57.0 Cardiogenic shock
R57.1 Hypovolaemic shock
R57.2 Septic shock
DChS.I.1
R57.8 Other shock
Incl.:
Endotoxic shock
R57.9 Shock, unspecified
Incl.:
Failure of peripheral circulation NOS

R58 Haemorrhage, not elsewhere classified

Incl.:
Haemorrhage NOS

R59 Enlarged lymph nodes

Incl.:
swollen glands
Excl.:
lymphadenitis:
R59.0 Localized enlarged lymph nodes
R59.1 Generalized enlarged lymph nodes
Incl.:
Lymphadenopathy NOS
Excl.:
HIV disease resulting in (persistent) generalized lymphadenopathy ( B23.1)
R59.9 Enlarged lymph nodes, unspecified

R60 Oedema, not elsewhere classified

Excl.:
ascites ( R18)
hydrops fetalis NOS ( P83.2)
hydrothorax ( J94.8)
oedema (of):
R60.0 Localized oedema
R60.1 Generalized oedema
R60.9 Oedema, unspecified
Incl.:
Fluid retention NOS

R61 Hyperhidrosis

R61.0 Localized hyperhidrosis
R61.1 Generalized hyperhidrosis
R61.9 Hyperhidrosis, unspecified
Incl.:
Excessive sweating
Night sweats

R62 Lack of expected normal physiological development

Excl.:
delayed puberty ( E30.0)
R62.0 Delayed milestone
Incl.:
Delayed attainment of expected physiological developmental stage
Late:
  • talker
  • walker
R62.8 Other lack of expected normal physiological development
Incl.:
Failure to:
  • gain weight
  • thrive
Infantilism NOS
Lack of growth
Physical retardation
Excl.:
HIV disease resulting in failure to thrive ( B22.2)
physical retardation due to malnutrition ( E45)
R62.9 Lack of expected normal physiological development, unspecified

R63 Symptoms and signs concerning food and fluid intake

Excl.:
bulimia NOS ( F50.2)
eating disorders of nonorganic origin ( F50.-)
malnutrition ( E40-E46)
R63.0 Anorexia
Incl.:
Loss of appetite
Excl.:
anorexia nervosa ( F50.0)
loss of appetite of nonorganic origin ( F50.8)
R63.1 Polydipsia
Incl.:
Excessive thirst
R63.2 Polyphagia
Incl.:
Excessive eating
Hyperalimentation NOS
R63.3 Feeding difficulties and mismanagement
Incl.:
Feeding problem NOS
Excl.:
feeding problems of newborn ( P92.-)
infant feeding disorder of nonorganic origin ( F98.2)
R63.4 Abnormal weight loss
R63.5 Abnormal weight gain
Excl.:
excessive weight gain in pregnancy ( O26.0)
obesity ( E66.-)
R63.6 Insufficient intake of food and water due to self neglect
Excl.:
starvation due to anorexia ( R63.0)
starvation due to privation of food ( X53)
thirst due to privation of water ( X54)
self neglect NOS ( R46.8)
R63.8 Other symptoms and signs concerning food and fluid intake

R64 Cachexia

Excl.:
HIV disease resulting in wasting syndrome ( B22.2)
malignant cachexia ( C80.-)
nutritional marasmus ( E41)

R65 Systemic Inflammatory Response Syndrome [SIRS]
DCS.XVIII.8 DChS.I.1

Note:
This category should never be used in primary coding. The category is for use in multiple coding to identify this condition resulting from any cause. A code from another chapter should be assigned first to indicate the cause or underlying disease.
R65.0 Systemic Inflammatory Response Syndrome of infectious origin without organ failure
R65.1 Systemic Inflammatory Response Syndrome of infectious origin with organ failure
Incl.:
Severe sepsis
R65.2 Systemic Inflammatory Response Syndrome of non-infectious origin without organ failure
R65.3 Systemic Inflammatory Response Syndrome of non-infectious origin with organ failure
R65.9 Systemic Inflammatory Response Syndrome, unspecified

R68 Other general symptoms and signs

R68.0 Hypothermia, not associated with low environmental temperature
Excl.:
hypothermia (due to)(of):
  • NOS (accidental) (T68)
  • anaesthesia (T88.5)
  • low environmental temperature (T68)
  • newborn (P80.-)
R68.1 Nonspecific symptoms peculiar to infancy
Incl.:
Excessive crying of infant
Irritable infant
Excl.:
neonatal cerebral irritability ( P91.3)
teething syndrome ( K00.7)
R68.2 Dry mouth, unspecified
Excl.:
dry mouth due to:
  • dehydration (E86)
  • sicca syndrome [Sjögren] (M35.0)
salivary gland hyposecretion ( K11.7)
R68.3 Clubbing of fingers
Incl.:
Clubbing of nails
Excl.:
congenital clubfinger ( Q68.1)
congenital clubnail ( Q84.6)
R68.8 Other specified general symptoms and signs
DCS.XVIII.10

R69 Unknown and unspecified causes of morbidity
DCS.XVIII.11

Incl.:
Illness NOS
Undiagnosed disease, not specified as to the site or system involved