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

ICD-10 R48.1

Billable / Specific

Agnosia

R48
Block
2
Synonyms
544
LCDs
15
Payer Policies
2
Linked CPTs

About ICD-10-CM R48.1

ICD-10-CM code R48.1 represents Agnosia. This is a billable/specific code in the Symptoms, Signs, and Abnormal Findings chapter (block R48). The 2026 edition of ICD-10-CM R48.1 became effective on October 1, 2025.

Inclusion Terms / Approximate Synonyms

Clinical terms and conditions classified under R48.1. Per CMS ICD-10-CM Tabular 2026.

  • Astereognosia (astereognosis)
  • Autotopagnosia

Type 1 Excludes

Pure excludes, these codes can never be coded together with R48.1. The conditions are mutually exclusive (e.g., congenital vs acquired forms).

  • visual object agnosia (R48.3)

Medicare LCD Coverage for R48.1

Local Coverage Determinations (LCDs) from CMS MACs that list R48.1 as a covered diagnosis.

544 LCDs

Showing top 10 of 544 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
Article ID: 54111, Effective: 2025-10-01 00:00:00, 1064 covered, 0 non-covered
CPT 92524 →
CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
Article ID: 54111, Effective: 2025-10-01 00:00:00, 1064 covered, 0 non-covered
CPT 96112 →
CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
Article ID: 54111, Effective: 2025-10-01 00:00:00, 1064 covered, 0 non-covered
CPT 92521 →
CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
Article ID: 54111, Effective: 2025-10-01 00:00:00, 1064 covered, 0 non-covered
CPT 97130 →
CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
Article ID: 54111, Effective: 2025-10-01 00:00:00, 1064 covered, 0 non-covered
CPT 97129 →
CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
Article ID: 54111, Effective: 2025-10-01 00:00:00, 1064 covered, 0 non-covered
CPT 92597 →
CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
Article ID: 54111, Effective: 2025-10-01 00:00:00, 1064 covered, 0 non-covered
CPT 97110 →
CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
Article ID: 54111, Effective: 2025-10-01 00:00:00, 1064 covered, 0 non-covered
CPT 97533 →
CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
Article ID: 54111, Effective: 2025-10-01 00:00:00, 1064 covered, 0 non-covered
CPT 96110 →
CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
Article ID: 54111, Effective: 2025-10-01 00:00:00, 1064 covered, 0 non-covered
CPT 92522 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing R48.1.

15 policies

1 Cigna

Diagnostic Nasal/Sinus Endoscopy, Functional Endoscopic Sinus Surgery (FESS) and Turbinectomy - (0554)
Policy ID: MM_0554

5 Medicare

Billing and Coding: Speech-Language Pathology
Policy ID: ART-52866
Billing and Coding: Home Health Speech-Language Pathology
Policy ID: ART-53052
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

CPT Codes Commonly Billed with R48.1

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

2 linkages
  • G0539 CMS LCD: Billing and Coding: Home Health Skilled Nursing Care-Teaching and Training: Alzheimer's Disease and Behavioral Disturbances CMS LCD
  • G0540 CMS LCD: Billing and Coding: Home Health Skilled Nursing Care-Teaching and Training: Alzheimer's Disease and Behavioral Disturbances CMS LCD

Convert R48.1 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
R48.1 78469 10000

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

ICD-10 R48.1, Billing FAQ

Is ICD-10 code R48.1 billable? +

Yes, R48.1 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 R48.1? +

ICD-10 R48.1 includes: Astereognosia (astereognosis); Autotopagnosia.

What codes are Type 1 Excludes for R48.1? +

Type 1 Excludes (never code together with R48.1): visual object agnosia (R48.3)

What CPT codes are commonly billed with R48.1? +

Procedures frequently paired with R48.1 include: G0539, G0540.

What ICD-9 codes does R48.1 map to? +

Per CMS GEMs, R48.1 maps to ICD-9 codes: 78469. 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 June 1, 2026.

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