2020 ICD-10-CM Diagnosis Code R78

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

    2016 2017 2018 2019 2020 Non-Billable/Non-Specific Code
  • R78 should not be used for reimbursement purposes as there are multiple codes below it that contain a greater level of detail.
  • Short description: Find of drugs and oth substnc, not normally found in blood
  • The 2020 edition of ICD-10-CM R78 became effective on October 1, 2019.
  • This is the American ICD-10-CM version of R78 - other international versions of ICD-10 R78 may differ.
Use Additional
Use Additional Help
Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. For such conditions the ICD-10-CM has a coding convention that requires the underlying condition be sequenced first followed by the manifestation. Wherever such a combination exists there is a "use additional code" note at the etiology code, and a "code first" note at the manifestation code. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. In most cases the manifestation codes will have in the code title, "in diseases classified elsewhere." Codes with this title are a component of the etiology/manifestation convention. The code title indicates that it is a manifestation code. "In diseases classified elsewhere" codes are never permitted to be used as first listed or principle diagnosis codes. They must be used in conjunction with an underlying condition code and they must be listed following the underlying condition.
  • code to identify the any retained foreign body, if applicable (
    ICD-10-CM Diagnosis Code Z18
    • Z18 Retained foreign body fragments
      • Z18.0 Retained radioactive fragments
        • Z18.01 Retained depleted uranium fragments
        • Z18.09 Other retained radioactive fragments
      • Z18.1 Retained metal fragments
        • Z18.10 …… unspecified
        • Z18.11 Retained magnetic metal fragments
        • Z18.12 Retained nonmagnetic metal fragments
      • Z18.2 Retained plastic fragments
      • Z18.3 Retained organic fragments
        • Z18.31 Retained animal quills or spines
        • Z18.32 Retained tooth
        • Z18.33 Retained wood fragments
        • Z18.39 Other retained organic fragments
      • Z18.8 Other specified retained foreign body
        • Z18.81 Retained glass fragments
        • Z18.83 Retained stone or crystalline fragments
        • Z18.89 Other specified retained foreign body fragmen...
      • Z18.9 Retained foreign body fragments, unspecified ...
    Z18.-
    )
Type 1 Excludes
Type 1 Excludes Help
A type 1 excludes note is a pure excludes. It means "not coded here". A type 1 excludes note indicates that the code excluded should never be used at the same time as R78. A type 1 excludes note is for used for when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition.
  • mental or behavioral disorders due to psychoactive substance use (F10-F19
    ICD-10-CM Range F10-F19

    Mental and behavioral disorders due to psychoactive substance use

    • F10 Alcohol related disorders
    • F11 Opioid related disorders
    • F12 Cannabis related disorders
    • F13 Sedative, hypnotic, or anxiolytic relate...
    • F14 Cocaine related disorders
    • F15 Other stimulant related disorders
    • F16 Hallucinogen related disorders
    • F17 Nicotine dependence
    • F18 Inhalant related disorders
    • F19 Other psychoactive substance related dis...
    )
The following code(s) above R78 contain annotation back-references
Annotation Back-References
In this context, annotation back-references refer to codes that contain:
  • Applicable To annotations, or
  • Code Also annotations, or
  • Code First annotations, or
  • Excludes1 annotations, or
  • Excludes2 annotations, or
  • Includes annotations, or
  • Note annotations, or
  • Use Additional annotations
that may be applicable to R78:
  • R00-R99
    2020 ICD-10-CM Range R00-R99

    Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified

    Note
    • This chapter includes symptoms, signs, abnormal results of clinical or other investigative procedures, and ill-defined conditions regarding which no diagnosis classifiable elsewhere is recorded.
    • Signs and symptoms that point rather definitely to a given diagnosis have been assigned to a category in other chapters of the classification. In general, categories in this chapter include the less well-defined conditions and symptoms that, without the necessary study of the case to establish a final diagnosis, point perhaps equally to two or more diseases or to two or more systems of the body. Practically all categories in the chapter could be designated 'not otherwise specified', 'unknown etiology' or 'transient'. The Alphabetical Index should be consulted to determine which symptoms and signs are to be allocated here and which to other chapters. The residual subcategories, numbered .8, are generally provided for other relevant symptoms that cannot be allocated elsewhere in the classification.
    • The conditions and signs or symptoms included in categories R00-R94 consist of:
    • (a) cases for which no more specific diagnosis can be made even after all the facts bearing on the case have been investigated;
    • (b) signs or symptoms existing at the time of initial encounter that proved to be transient and whose causes could not be determined;
    • (c) provisional diagnosis in a patient who failed to return for further investigation or care;
    • (d) cases referred elsewhere for investigation or treatment before the diagnosis was made;
    • (e) cases in which a more precise diagnosis was not available for any other reason;
    • (f) certain symptoms, for which supplementary information is provided, that represent important problems in medical care in their own right.
    Type 2 Excludes
    • abnormal findings on antenatal screening of mother (O28.-)
    • certain conditions originating in the perinatal period (P04-P96)
    • signs and symptoms classified in the body system chapters
    • signs and symptoms of breast (N63, N64.5)
    Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified
  • R70-R79
    2020 ICD-10-CM Range R70-R79

    Abnormal findings on examination of blood, without diagnosis

    Type 2 Excludes
    • abnormal findings on antenatal screening of mother (O28.-)
    • abnormalities of lipids (E78.-)
    • abnormalities of platelets and thrombocytes (D69.-)
    • abnormalities of white blood cells classified elsewhere (D70-D72)
    • coagulation hemorrhagic disorders (D65-D68)
    • diagnostic abnormal findings classified elsewhere - see Alphabetical Index
    • hemorrhagic and hematological disorders of newborn (P50-P61)
    Abnormal findings on examination of blood, without diagnosis
Code History
  • 2016 (effective 10/1/2015): New code (first year of non-draft ICD-10-CM)
  • 2017 (effective 10/1/2016): No change
  • 2018 (effective 10/1/2017): No change
  • 2019 (effective 10/1/2018): No change
  • 2020 (effective 10/1/2019): No change
Code annotations containing back-references to R78:
  • Use Additional: Z02.83
    ICD-10-CM Diagnosis Code Z02.83

    Encounter for blood-alcohol and blood-drug test

      2016 2017 2018 2019 2020 Billable/Specific Code POA Exempt
    Use Additional
    • code for findings of alcohol or drugs in blood (R78.-)
ICD-10-CM Codes Adjacent To R78
R76.11 Nonspecific reaction to tuberculin skin test without active tuberculosis
R76.12 Nonspecific reaction to cell mediated immunity measurement of gamma interferon antigen response without active tuberculosis
R76.8 Other specified abnormal immunological findings in serum
R76.9 Abnormal immunological finding in serum, unspecified
R77 Other abnormalities of plasma proteins
R77.0 Abnormality of albumin
R77.1 Abnormality of globulin
R77.2 Abnormality of alphafetoprotein
R77.8 Other specified abnormalities of plasma proteins
R77.9 Abnormality of plasma protein, unspecified
R78 Findings of drugs and other substances, not normally found in blood
R78.0 Finding of alcohol in blood
R78.1 Finding of opiate drug in blood
R78.2 Finding of cocaine in blood
R78.3 Finding of hallucinogen in blood
R78.4 Finding of other drugs of addictive potential in blood
R78.5 Finding of other psychotropic drug in blood
R78.6 Finding of steroid agent in blood
R78.7 Finding of abnormal level of heavy metals in blood
R78.71 Abnormal lead level in blood
R78.79 Finding of abnormal level of heavy metals in blood

Reimbursement claims with a date of service on or after October 1, 2015 require the use of ICD-10-CM codes.