ICD-10 R62.5
Non-Billable HeaderOther and unspecified lack of expected normal physiological development in childhood
About ICD-10-CM R62.5
ICD-10-CM code R62.5 represents Other and unspecified lack of expected normal physiological development in childhood. This is a non-billable header code in the Symptoms, Signs, and Abnormal Findings chapter (block R62). The 2026 edition of ICD-10-CM R62.5 became effective on October 1, 2025. Non-billable codes cannot be used as a primary or secondary diagnosis on a claim, use a more specific child code instead.
Type 1 Excludes
Pure excludes, these codes can never be coded together with R62.5. The conditions are mutually exclusive (e.g., congenital vs acquired forms).
- HIV disease resulting in failure to thrive (B20)
- physical retardation due to malnutrition (E45)
Medicare LCD Coverage for R62.5
Local Coverage Determinations (LCDs) from CMS MACs that list R62.5 as a covered diagnosis.
This doesn't mean the code isn't covered, it means no MAC has issued a Local Coverage Determination naming this specific code. Coverage may still apply under National Coverage Determinations or general medical-necessity rules.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing R62.5.
Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but R62.5 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.
CPT Codes Commonly Billed with R62.5
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
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.
Codes Adjacent To R62.5
Other codes in section R50-R69 (General symptoms and signs).
ICD-10 R62.5, Billing FAQ
Is ICD-10 code R62.5 billable? +
No, R62.5 is a non-billable header code. Use a more specific child code from block R62 when submitting claims.
What codes are Type 1 Excludes for R62.5? +
Type 1 Excludes (never code together with R62.5): HIV disease resulting in failure to thrive (B20); physical retardation due to malnutrition (E45)
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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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