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ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 R07.1

Billable / Specific

Chest pain on breathing

R07
Block
1
Synonyms
503
LCDs
29
Payer Policies
3
Linked CPTs

About ICD-10-CM R07.1

ICD-10-CM code R07.1 represents Chest pain on breathing. This is a billable/specific code in the Symptoms, Signs, and Abnormal Findings chapter (block R07). The 2026 edition of ICD-10-CM R07.1 became effective on October 1, 2025.

Inclusion Terms / Approximate Synonyms

Clinical terms and conditions classified under R07.1. Per CMS ICD-10-CM Tabular 2026.

  • Painful respiration

Medicare LCD Coverage for R07.1

Local Coverage Determinations (LCDs) from CMS MACs that list R07.1 as a covered diagnosis.

503 LCDs

Showing top 10 of 503 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Ambulatory Electrocardiograph (AECG) Monitoring
Article ID: 59270, Effective: 2025-01-01 00:00:00, 153 covered, 0 non-covered
CPT 93270 →
CMS LCD: Billing and Coding: Ambulatory Electrocardiograph (AECG) Monitoring
Article ID: 59270, Effective: 2025-01-01 00:00:00, 153 covered, 0 non-covered
CPT 93298 →
CMS LCD: Billing and Coding: Ambulatory Electrocardiograph (AECG) Monitoring
Article ID: 59270, Effective: 2025-01-01 00:00:00, 153 covered, 0 non-covered
CPT 93225 →
CMS LCD: Billing and Coding: Ambulatory Electrocardiograph (AECG) Monitoring
Article ID: 59270, Effective: 2025-01-01 00:00:00, 153 covered, 0 non-covered
CPT 93271 →
CMS LCD: Billing and Coding: Ambulatory Electrocardiograph (AECG) Monitoring
Article ID: 59270, Effective: 2025-01-01 00:00:00, 153 covered, 0 non-covered
CPT 93246 →
CMS LCD: Billing and Coding: Ambulatory Electrocardiograph (AECG) Monitoring
Article ID: 59270, Effective: 2025-01-01 00:00:00, 153 covered, 0 non-covered
CPT 93272 →
CMS LCD: Billing and Coding: Ambulatory Electrocardiograph (AECG) Monitoring
Article ID: 59270, Effective: 2025-01-01 00:00:00, 153 covered, 0 non-covered
CPT 93242 →
CMS LCD: Billing and Coding: Ambulatory Electrocardiograph (AECG) Monitoring
Article ID: 59270, Effective: 2025-01-01 00:00:00, 153 covered, 0 non-covered
CPT 93228 →
CMS LCD: Billing and Coding: Ambulatory Electrocardiograph (AECG) Monitoring
Article ID: 59270, Effective: 2025-01-01 00:00:00, 153 covered, 0 non-covered
CPT 0938T →
CMS LCD: Billing and Coding: Ambulatory Electrocardiograph (AECG) Monitoring
Article ID: 59270, Effective: 2025-01-01 00:00:00, 153 covered, 0 non-covered
CPT 0937T →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing R07.1.

29 policies

5 Medicare

Billing and Coding: Nerve Blockade for Treatment of Chronic Pain and Neuropathy
Policy ID: ART-56034
Billing and Coding: Computerized Axial Tomography (CT), Thorax
Policy ID: ART-56580
Billing and Coding: Continuous Peripheral Nerve Blocks (CPNB)
Policy ID: ART-56607
Billing and Coding: Echocardiography
Policy ID: ART-56625
Billing and Coding: Non-Invasive Vascular Studies
Policy ID: ART-56697

CPT Codes Commonly Billed with R07.1

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

3 linkages
  • 93015 Stress test — chest pain, palpitations, syncope, known CAD Cardiovascular Disease
  • 93458 Left heart catheterization — CAD, ACS, chest pain Cardiovascular Disease
  • 91035 Esophageal pH monitoring — GERD evaluation, heartburn, retrosternal chest pain, dysphagia, asthma with suspected GERD, chronic cough, Barrett Gastroenterology

Convert R07.1 to ICD-9-CM

Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.

ICD-10ICD-9Mapping Flags
R07.1 78652 10000

Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).

ICD-10 R07.1, Billing FAQ

Is ICD-10 code R07.1 billable? +

Yes, R07.1 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What other names or terms map to R07.1? +

ICD-10 R07.1 includes: Painful respiration.

What CPT codes are commonly billed with R07.1? +

Procedures frequently paired with R07.1 include: 93015, 93458, 91035.

What ICD-9 codes does R07.1 map to? +

Per CMS GEMs, R07.1 maps to ICD-9 codes: 78652. Useful for legacy data review and historical claim analysis.

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Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on July 16, 2026.

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