ICD-10 R07
Non-Billable HeaderPain in throat and chest
About ICD-10-CM R07
ICD-10-CM code R07 represents Pain in throat and chest. This is a non-billable header code in the Symptoms, Signs, and Abnormal Findings chapter (block R07). The 2026 edition of ICD-10-CM R07 became effective on October 1, 2025. Non-billable codes cannot be used as a primary or secondary diagnosis on a claim, use a more specific child code instead.
Type 1 Excludes
Pure excludes, these codes can never be coded together with R07. The conditions are mutually exclusive (e.g., congenital vs acquired forms).
- epidemic myalgia (B33.0)
Type 2 Excludes
Not included here, the excluded code is not part of R07, but a patient may have both conditions at the same time. Both codes may be coded together when applicable.
- jaw pain R68.84
- pain in breast (N64.4)
Medicare LCD Coverage for R07
Local Coverage Determinations (LCDs) from CMS MACs that list R07 as a covered diagnosis.
This doesn't mean the code isn't covered, it means no MAC has issued a Local Coverage Determination naming this specific code. Coverage may still apply under National Coverage Determinations or general medical-necessity rules.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing R07.
Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but R07 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.
Codes Adjacent To R07
Other codes in section R00-R09 (Symptoms and signs involving the circulatory and respiratory systems).
ICD-10 R07, Billing FAQ
Is ICD-10 code R07 billable? +
No, R07 is a non-billable header code. Use a more specific child code from block R07 when submitting claims.
What codes are Type 1 Excludes for R07? +
Type 1 Excludes (never code together with R07): epidemic myalgia (B33.0)
What codes are Type 2 Excludes for R07? +
Type 2 Excludes (may be coded together when both conditions exist): jaw pain R68.84; pain in breast (N64.4)
What CPT codes are commonly billed with R07? +
Procedures frequently paired with R07 include: 99213, 94750.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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