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

ICD-10 R78

Non-Billable Header

Findings of drugs and other substances, not normally found in blood

R78
Block
0
Synonyms
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LCDs
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Payer Policies
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Linked CPTs

About ICD-10-CM R78

ICD-10-CM code R78 represents Findings of drugs and other substances, not normally found in blood. This is a non-billable header code in the Symptoms, Signs, and Abnormal Findings chapter (block R78). The 2026 edition of ICD-10-CM R78 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 2 Excludes

Not included here, the excluded code is not part of R78, but a patient may have both conditions at the same time. Both codes may be coded together when applicable.

  • mental or behavioral disorders due to psychoactive substance use (F10-F19)

Use Additional Code

When coding R78, also report these additional codes when applicable.

  • code to identify the any retained foreign body, if applicable (Z18.-)

Medicare LCD Coverage for R78

Local Coverage Determinations (LCDs) from CMS MACs that list R78 as a covered diagnosis.

No Medicare LCDs reference R78 as covered

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 R78.

No commercial payer policies reference R78 on file

Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but R78 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.

CPT Codes Commonly Billed with R78

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

No procedure linkages on file for R78

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.

ICD-10 R78, Billing FAQ

Is ICD-10 code R78 billable? +

No, R78 is a non-billable header code. Use a more specific child code from block R78 when submitting claims.

What codes are Type 2 Excludes for R78? +

Type 2 Excludes (may be coded together when both conditions exist): mental or behavioral disorders due to psychoactive substance use (F10-F19)

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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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