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

ICD-10 R51.9

Billable / Specific

Headache, unspecified

R51
Block
1
Synonyms
65
LCDs
13
Payer Policies
9
Linked CPTs

About ICD-10-CM R51.9

ICD-10-CM code R51.9 represents Headache, unspecified. This is a billable/specific code in the Symptoms, Signs, and Abnormal Findings chapter (block R51). The 2026 edition of ICD-10-CM R51.9 became effective on October 1, 2025.

Coding Tips for R51.9

Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.

Specificity warning

Headache unspecified. Use a more specific code if migraine, tension, cluster, or post-traumatic headache is documented.

Inclusion Terms / Approximate Synonyms

Clinical terms and conditions classified under R51.9. Per CMS ICD-10-CM Tabular 2026.

  • Facial pain NOS

Medicare LCD Coverage for R51.9

Local Coverage Determinations (LCDs) from CMS MACs that list R51.9 as a covered diagnosis.

65 LCDs

Showing top 10 of 65 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Chiropractic Services
Article ID: 56273, Effective: 2025-08-28 00:00:00, 315 covered, 0 non-covered
CPT 98942 →
CMS LCD: Billing and Coding: Chiropractic Services
Article ID: 56273, Effective: 2025-08-28 00:00:00, 315 covered, 0 non-covered
CPT 98940 →
CMS LCD: Billing and Coding: Chiropractic Services
Article ID: 56273, Effective: 2025-08-28 00:00:00, 315 covered, 0 non-covered
CPT 98941 →
CMS LCD: Billing and Coding: Chiropractic Services
Article ID: 56273, Effective: 2025-08-28 00:00:00, 315 covered, 0 non-covered
CPT 98943 →
CMS LCD: Billing and Coding: Peripheral Nerve Blocks
Article ID: 57452, Effective: 2025-10-01 00:00:00, 1570 covered, 0 non-covered
CPT 64420 →
CMS LCD: Billing and Coding: Peripheral Nerve Blocks
Article ID: 57452, Effective: 2025-10-01 00:00:00, 1570 covered, 0 non-covered
CPT 20561 →
CMS LCD: Billing and Coding: Peripheral Nerve Blocks
Article ID: 57452, Effective: 2025-10-01 00:00:00, 1570 covered, 0 non-covered
CPT 64415 →
CMS LCD: Billing and Coding: Peripheral Nerve Blocks
Article ID: 57452, Effective: 2025-10-01 00:00:00, 1570 covered, 0 non-covered
CPT 64447 →
CMS LCD: Billing and Coding: Peripheral Nerve Blocks
Article ID: 57452, Effective: 2025-10-01 00:00:00, 1570 covered, 0 non-covered
CPT 64448 →
CMS LCD: Billing and Coding: Peripheral Nerve Blocks
Article ID: 57452, Effective: 2025-10-01 00:00:00, 1570 covered, 0 non-covered
CPT 64416 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing R51.9.

13 policies

5 Aetna

Magnetic Resonance Angiography (MRA) and Magnetic Resonance Venography (MRV) - Medical Clinical Policy Bulletins | Aetna
Policy ID: CPB-0094
Chiropractic Services
Policy ID: CPB-0107
Acupuncture and Dry Needling
Policy ID: CPB-0135
Influenza Rapid Diagnostic Tests
Policy ID: CPB-0476
Lead Testing
Policy ID: CPB-0553

4 Cigna

Acupuncture - (CPG024)
Policy ID: CPG024_ACUPUNCTURE
Headache, Occipital, and/or Trigeminal Neuralgia Treatment - (0063)
Policy ID: MM_0063
Nucleic Acid Pathogen Testing - (0530)
Policy ID: MM_0530
Peripheral Nerve Destruction for Pain Conditions - (0525) ---- future effective policy
Policy ID: MM_0525

4 Medicare

Billing and Coding: Chiropractic Services
Policy ID: ART-56273
Billing and Coding: CT of the Head
Policy ID: ART-56612
Billing and Coding: MRI and CT Scans of the Head and Neck
Policy ID: ART-57204
Billing and Coding: Peripheral Nerve Blocks
Policy ID: ART-57452

CPT Codes Commonly Billed with R51.9

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

9 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
  • 99213 Established patient — HTN follow-up, diabetes management, hyperlipidemia, asthma, anxiety, common complaints, back pain, GERD, migraine, acne, joint pain, prediabetes, obesity, anemia, hypothyroid, fatigue Primary Care
  • 93880 Duplex carotid — stroke, TIA, carotid stenosis, cerebral atherosclerosis, syncope, migraine, dizziness, headache, family hx vascular disease Cardiology
  • 70553 MRI brain with and without contrast — migraine, headache, encephalopathy, brain cancer, epilepsy, brain neoplasm, cognitive decline, MS, hydrocephalus, aphasia, numbness Radiology
  • 70551 MRI brain without contrast — migraine, headache, encephalopathy, cognitive decline, MS, epilepsy, syncope, dizziness Radiology
  • 95819 EEG awake and asleep — epilepsy, generalized seizures, absence seizures, focal seizures, seizure NOS, fasciculations, syncope, encephalopathy, cognitive decline, aphasia, migraine, headache, insomnia Neurology
  • 95165 Botox injection for migraine — chronic migraine, migraine with aura, migraine without aura, menstrual migraine, other migraine, headache Neurology

ICD-10 R51.9, Billing FAQ

Is ICD-10 code R51.9 billable? +

Yes, R51.9 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 R51.9? +

ICD-10 R51.9 includes: Facial pain NOS.

What CPT codes are commonly billed with R51.9? +

Procedures frequently paired with R51.9 include: 99202, 99203, 99212, 99213, 93880.

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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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