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

ICD-10 R53.1

Billable / Specific

Weakness

R53
Block
1
Synonyms
246
LCDs
20
Payer Policies
0
Linked CPTs

About ICD-10-CM R53.1

ICD-10-CM code R53.1 represents Weakness. This is a billable/specific code in the Symptoms, Signs, and Abnormal Findings chapter (block R53). The 2026 edition of ICD-10-CM R53.1 became effective on October 1, 2025.

Inclusion Terms / Approximate Synonyms

Clinical terms and conditions classified under R53.1. Per CMS ICD-10-CM Tabular 2026.

  • Asthenia NOS

Type 1 Excludes

Pure excludes, these codes can never be coded together with R53.1. The conditions are mutually exclusive (e.g., congenital vs acquired forms).

  • age-related weakness (R54)
  • muscle weakness (generalized) (M62.81)
  • sarcopenia (M62.84)
  • senile asthenia (R54)

Medicare LCD Coverage for R53.1

Local Coverage Determinations (LCDs) from CMS MACs that list R53.1 as a covered diagnosis.

246 LCDs

Showing top 10 of 246 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Magnesium
Article ID: 59186, Effective: 2025-10-01 00:00:00, 4358 covered, 0 non-covered
CPT 83735 →
CMS LCD: Billing and Coding: Nerve Conduction Studies and Electromyography
Article ID: 57668, Effective: 2025-10-01 00:00:00, 1629 covered, 0 non-covered
CPT 95909 →
CMS LCD: Billing and Coding: Nerve Conduction Studies and Electromyography
Article ID: 57668, Effective: 2025-10-01 00:00:00, 1629 covered, 0 non-covered
CPT 95887 →
CMS LCD: Billing and Coding: Nerve Conduction Studies and Electromyography
Article ID: 57668, Effective: 2025-10-01 00:00:00, 1629 covered, 0 non-covered
CPT 95912 →
CMS LCD: Billing and Coding: Nerve Conduction Studies and Electromyography
Article ID: 57668, Effective: 2025-10-01 00:00:00, 1629 covered, 0 non-covered
CPT 95999 →
CMS LCD: Billing and Coding: Nerve Conduction Studies and Electromyography
Article ID: 57668, Effective: 2025-10-01 00:00:00, 1629 covered, 0 non-covered
CPT 95910 →
CMS LCD: Billing and Coding: Nerve Conduction Studies and Electromyography
Article ID: 57668, Effective: 2025-10-01 00:00:00, 1629 covered, 0 non-covered
CPT 95870 →
CMS LCD: Billing and Coding: Nerve Conduction Studies and Electromyography
Article ID: 57668, Effective: 2025-10-01 00:00:00, 1629 covered, 0 non-covered
CPT 95860 →
CMS LCD: Billing and Coding: Nerve Conduction Studies and Electromyography
Article ID: 57668, Effective: 2025-10-01 00:00:00, 1629 covered, 0 non-covered
CPT 95913 →
CMS LCD: Billing and Coding: Nerve Conduction Studies and Electromyography
Article ID: 57668, Effective: 2025-10-01 00:00:00, 1629 covered, 0 non-covered
CPT 95869 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing R53.1.

20 policies

3 Aetna

Obstructive Sleep Apnea in Adults - Medical Clinical Policy Bulletins | Aetna
Policy ID: CPB-0004
Bathroom and Toilet Equipment and Supplies
Policy ID: CPB-0429
Therapeutic Chairs
Policy ID: CPB-0434

5 Medicare

Billing and Coding: Nerve Conduction Studies and Electromyography
Policy ID: ART-54969
Billing and Coding: CT of the Head
Policy ID: ART-56612
Billing and Coding: Nerve Conduction Studies and Electromyography
Policy ID: ART-56619
Billing and Coding: Magnetic Resonance Angiography (MRA)
Policy ID: ART-56747
Billing and Coding: Parathormone (Parathyroid Hormone)
Policy ID: ART-57122

CPT Codes Commonly Billed with R53.1

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

No procedure linkages on file for R53.1

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 R53.1 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
R53.1 78079 10000

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

ICD-10 R53.1, Billing FAQ

Is ICD-10 code R53.1 billable? +

Yes, R53.1 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 R53.1? +

ICD-10 R53.1 includes: Asthenia NOS.

What codes are Type 1 Excludes for R53.1? +

Type 1 Excludes (never code together with R53.1): age-related weakness (R54); muscle weakness (generalized) (M62.81); sarcopenia (M62.84)

What ICD-9 codes does R53.1 map to? +

Per CMS GEMs, R53.1 maps to ICD-9 codes: 78079. 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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