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

ICD-10 R42

Billable / Specific

Dizziness and giddiness

R42
Block
2
Synonyms
669
LCDs
30
Payer Policies
7
Linked CPTs

About ICD-10-CM R42

ICD-10-CM code R42 represents Dizziness and giddiness. This is a billable/specific code in the Symptoms, Signs, and Abnormal Findings chapter (block R42). The 2026 edition of ICD-10-CM R42 became effective on October 1, 2025.

Inclusion Terms / Approximate Synonyms

Clinical terms and conditions classified under R42. Per CMS ICD-10-CM Tabular 2026.

  • Light-headedness
  • Vertigo NOS

Type 1 Excludes

Pure excludes, these codes can never be coded together with R42. The conditions are mutually exclusive (e.g., congenital vs acquired forms).

  • vertiginous syndromes (H81.-)
  • vertigo from infrasound (T75.23)

Medicare LCD Coverage for R42

Local Coverage Determinations (LCDs) from CMS MACs that list R42 as a covered diagnosis.

669 LCDs

Showing top 10 of 669 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Vestibular Function Tests
Article ID: 57118, Effective: , 46 covered, 1 non-covered
CPT 92538 →
CMS LCD: Billing and Coding: Vestibular Function Tests
Article ID: 57118, Effective: , 46 covered, 1 non-covered
CPT 92542 →
CMS LCD: Billing and Coding: Vestibular Function Tests
Article ID: 57118, Effective: , 46 covered, 1 non-covered
CPT 92537 →
CMS LCD: Billing and Coding: Vestibular Function Tests
Article ID: 57118, Effective: , 46 covered, 1 non-covered
CPT 92545 →
CMS LCD: Billing and Coding: Vestibular Function Tests
Article ID: 57118, Effective: , 46 covered, 1 non-covered
CPT 92541 →
CMS LCD: Billing and Coding: Vestibular Function Tests
Article ID: 57118, Effective: , 46 covered, 1 non-covered
CPT 92540 →
CMS LCD: Billing and Coding: Vestibular Function Tests
Article ID: 57118, Effective: , 46 covered, 1 non-covered
CPT 92544 →
CMS LCD: Billing and Coding: Vestibular Function Tests
Article ID: 57118, Effective: , 46 covered, 1 non-covered
CPT 92547 →
CMS LCD: Billing and Coding: Vestibular Function Tests
Article ID: 57118, Effective: , 46 covered, 1 non-covered
CPT 92546 →
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 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing R42.

30 policies

2 Aetna

Holter Monitors - Medical Clinical Policy Bulletins | Aetna
Policy ID: CPB-0019
Cardiac Event Monitors - Medical Clinical Policy Bulletins | Aetna
Policy ID: CPB-0073

3 Cigna

Duplex Scan of Extracranial Arteries - (0542)
Policy ID: MM_0542
Transthoracic Echocardiography in Adults - (0510)
Policy ID: MM_0510
Transthoracic Echocardiography in Children - (0523)
Policy ID: MM_0523

5 Medicare

Billing and Coding: Home Health Occupational Therapy
Policy ID: ART-53057
Billing and Coding: Home Health Physical Therapy
Policy ID: ART-53058
Billing and Coding: Outpatient Occupational Therapy
Policy ID: ART-53064
Billing and Coding: Outpatient Physical Therapy
Policy ID: ART-53065
Billing and Coding: Cardiac Event Detection
Policy ID: ART-56452

CPT Codes Commonly Billed with R42

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

7 linkages
  • 99202 New patient office visit — fever, headache, abdominal pain, cough, dyspnea, fatigue, dizziness, limb pain, nausea, routine exam, URI, UTI, pharyngitis, otitis, chest pain, weight loss Primary Care
  • 99203 New patient office visit — common complaints plus chronic conditions: HTN, diabetes, hyperlipidemia, asthma, GERD, back pain, migraine, tachycardia, prediabetes Primary Care
  • 99212 Established patient — URI, UTI, pharyngitis, otitis, dermatitis, rash, viral infection, cellulitis, conjunctivitis, sinusitis, bronchitis, ankle sprain Primary Care
  • 93880 Duplex carotid — stroke, TIA, carotid stenosis, cerebral atherosclerosis, syncope, migraine, dizziness, headache, family hx vascular disease Cardiology
  • 70551 MRI brain without contrast — migraine, headache, encephalopathy, cognitive decline, MS, epilepsy, syncope, dizziness Radiology
  • 99281 ED visit level 1 — fever, cough, URI, abdominal pain, dizziness, laceration, ankle sprain, nausea, minor injury Emergency Medicine
  • 99283 ED visit level 3 — chest pain, dyspnea, pneumonia, UTI, forearm fracture, tibia fracture, syncope, GI bleed Emergency Medicine

Convert R42 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
R42 7804 00000

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

ICD-10 R42, Billing FAQ

Is ICD-10 code R42 billable? +

Yes, R42 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 R42? +

ICD-10 R42 includes: Light-headedness; Vertigo NOS.

What codes are Type 1 Excludes for R42? +

Type 1 Excludes (never code together with R42): vertiginous syndromes (H81.-); vertigo from infrasound (T75.23)

What CPT codes are commonly billed with R42? +

Procedures frequently paired with R42 include: 99202, 99203, 99212, 93880, 70551.

What ICD-9 codes does R42 map to? +

Per CMS GEMs, R42 maps to ICD-9 codes: 7804. 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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