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

ICD-10 R52

Billable / Specific

Pain, unspecified

R52
Block
3
Synonyms
225
LCDs
6
Payer Policies
0
Linked CPTs

About ICD-10-CM R52

ICD-10-CM code R52 represents Pain, unspecified. This is a billable/specific code in the Symptoms, Signs, and Abnormal Findings chapter (block R52). The 2026 edition of ICD-10-CM R52 became effective on October 1, 2025.

Inclusion Terms / Approximate Synonyms

Clinical terms and conditions classified under R52. Per CMS ICD-10-CM Tabular 2026.

  • Acute pain NOS
  • Generalized pain NOS
  • Pain NOS

Type 1 Excludes

Pure excludes, these codes can never be coded together with R52. The conditions are mutually exclusive (e.g., congenital vs acquired forms).

  • acute and chronic pain, not elsewhere classified (G89.-)
  • localized pain, unspecified type - code to pain by site, such as:
  • abdomen pain (R10.-)
  • back pain (M54.9)
  • breast pain (N64.4)
  • chest pain (R07.1-R07.9)
  • ear pain (H92.0-)
  • eye pain (H57.1)
  • headache (R51.9)
  • joint pain (M25.5-)
  • limb pain (M79.6-)
  • lumbar region pain (M54.5-)
  • pelvic and perineal pain (R10.2-)
  • shoulder pain (M25.51-)
  • spine pain (M54.-)
  • throat pain (R07.0)
  • tongue pain (K14.6)
  • tooth pain (K08.8)
  • renal colic (N23)
  • pain disorders exclusively related to psychological factors (F45.41)

Medicare LCD Coverage for R52

Local Coverage Determinations (LCDs) from CMS MACs that list R52 as a covered diagnosis.

225 LCDs

Showing top 10 of 225 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Continuous Peripheral Nerve Blocks (CPNB)
Article ID: 56607, Effective: 2025-10-01 00:00:00, 604 covered, 0 non-covered
CPT 64416 →
CMS LCD: Billing and Coding: Continuous Peripheral Nerve Blocks (CPNB)
Article ID: 56607, Effective: 2025-10-01 00:00:00, 604 covered, 0 non-covered
CPT 64446 →
CMS LCD: Billing and Coding: Continuous Peripheral Nerve Blocks (CPNB)
Article ID: 56607, Effective: 2025-10-01 00:00:00, 604 covered, 0 non-covered
CPT 64448 →
CMS LCD: Billing and Coding: Continuous Peripheral Nerve Blocks (CPNB)
Article ID: 56607, Effective: 2025-10-01 00:00:00, 604 covered, 0 non-covered
CPT 64449 →
CMS LCD: Billing and Coding: Pharmacogenomics Testing
Article ID: 58801, Effective: 2026-01-01 00:00:00, 578 covered, 0 non-covered
CPT 81227 →
CMS LCD: Billing and Coding: Pharmacogenomics Testing
Article ID: 58801, Effective: 2026-01-01 00:00:00, 578 covered, 0 non-covered
CPT 81328 →
CMS LCD: Billing and Coding: Pharmacogenomics Testing
Article ID: 58801, Effective: 2026-01-01 00:00:00, 578 covered, 0 non-covered
CPT 81335 →
CMS LCD: Billing and Coding: Pharmacogenomics Testing
Article ID: 58801, Effective: 2026-01-01 00:00:00, 578 covered, 0 non-covered
CPT 0071U →
CMS LCD: Billing and Coding: Pharmacogenomics Testing
Article ID: 58801, Effective: 2026-01-01 00:00:00, 578 covered, 0 non-covered
CPT 81383 →
CMS LCD: Billing and Coding: Pharmacogenomics Testing
Article ID: 58801, Effective: 2026-01-01 00:00:00, 578 covered, 0 non-covered
CPT 81418 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing R52.

6 policies

5 Medicare

Billing and Coding: Continuous Peripheral Nerve Blocks (CPNB)
Policy ID: ART-56607
Billing and Coding: Removal of Benign Skin Lesions
Policy ID: ART-57044
Billing and Coding: Removal of Benign Skin Lesions
Policy ID: ART-57113
Billing and Coding: Pharmacogenomics Testing
Policy ID: ART-58801
Billing and Coding: Pharmacogenomics Testing
Policy ID: ART-58812

CPT Codes Commonly Billed with R52

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

No procedure linkages on file for R52

We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.

Convert R52 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
R52 33819 10000
R52 78096 10000

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

ICD-10 R52, Billing FAQ

Is ICD-10 code R52 billable? +

Yes, R52 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 R52? +

ICD-10 R52 includes: Acute pain NOS; Generalized pain NOS; Pain NOS.

What codes are Type 1 Excludes for R52? +

Type 1 Excludes (never code together with R52): acute and chronic pain, not elsewhere classified (G89.-); localized pain, unspecified type - code to pain by site, such as:; abdomen pain (R10.-)

What ICD-9 codes does R52 map to? +

Per CMS GEMs, R52 maps to ICD-9 codes: 33819, 78096. 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 May 31, 2026.

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