ICD-10 R55
Billable / SpecificSyncope and collapse
About ICD-10-CM R55
ICD-10-CM code R55 represents Syncope and collapse. This is a billable/specific code in the Symptoms, Signs, and Abnormal Findings chapter (block R55). The 2026 edition of ICD-10-CM R55 became effective on October 1, 2025.
Inclusion Terms / Approximate Synonyms
Clinical terms and conditions classified under R55. Per CMS ICD-10-CM Tabular 2026.
- Blackout
- Fainting
- Vasovagal attack
Type 1 Excludes
Pure excludes, these codes can never be coded together with R55. The conditions are mutually exclusive (e.g., congenital vs acquired forms).
- cardiogenic shock (R57.0)
- carotid sinus syncope (G90.01)
- heat syncope (T67.1)
- neurocirculatory asthenia (F45.8)
- neurogenic orthostatic hypotension (G90.3)
- orthostatic hypotension (I95.1)
- postprocedural shock (T81.1-)
- psychogenic syncope (F48.8)
- shock NOS (R57.9)
- shock complicating or following abortion or ectopic or molar pregnancy (O00-O07, O08.3)
- shock complicating or following labor and delivery (O75.1)
- Stokes-Adams attack (I45.9)
- unconsciousness NOS (R40.2-)
Medicare LCD Coverage for R55
Local Coverage Determinations (LCDs) from CMS MACs that list R55 as a covered diagnosis.
Showing top 10 of 686 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing R55.
4 Aetna
3 Cigna
5 Medicare
CPT Codes Commonly Billed with R55
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
- 93015 Stress test — chest pain, palpitations, syncope, known CAD Cardiovascular Disease
- 99285 High-level ER E/M — MI, cardiac arrest, respiratory failure, chest pain, syncope, head injury Emergency Medicine
- 99281 Emergency department visit for level 1 patient Emergency Medicine
- 99282 Emergency department visit for level 2 patient Emergency Medicine
- 99283 Emergency department visit for level 3 patient Emergency Medicine
- 99284 Emergency department visit for level 4 patient Emergency Medicine
- 99285 Emergency department visit for level 5 patient Emergency Medicine
- 99205 New patient office visit — complex/high-risk: uncontrolled diabetes, heart failure, COPD exacerbation, cancer, MS, RA, CKD, CAD, recurrent depression, epilepsy, lupus, syncope, cognitive decline Primary Care
- 99215 Established patient — high complexity: HF exacerbation, COPD exacerbation, cancer management, MS, advanced CKD, uncontrolled diabetes, recurrent syncope, respiratory failure, liver cirrhosis Primary Care
- 93000 EKG 12-lead — tachycardia, bradycardia, palpitations, HTN, CAD, AFib, arrhythmia, chest pain, syncope, cardiomyopathy, AV block, bundle branch block, SVT, VT, diabetes screening, abnormal EKG Cardiology
Convert R55 to ICD-9-CM
Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.
| ICD-10 | ICD-9 | Mapping Flags |
|---|---|---|
| R55 | 7802 | 00000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To R55
Other codes in section R50-R69 (General symptoms and signs).
ICD-10 R55, Billing FAQ
Is ICD-10 code R55 billable? +
Yes, R55 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 R55? +
ICD-10 R55 includes: Blackout; Fainting; Vasovagal attack.
What codes are Type 1 Excludes for R55? +
Type 1 Excludes (never code together with R55): cardiogenic shock (R57.0); carotid sinus syncope (G90.01); heat syncope (T67.1)
What CPT codes are commonly billed with R55? +
Procedures frequently paired with R55 include: 93015, 99285, 99281, 99282, 99283.
What ICD-9 codes does R55 map to? +
Per CMS GEMs, R55 maps to ICD-9 codes: 7802. 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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