R03.1
BillableNonspecific low blood-pressure reading
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is R03.1 an HCC code?
No. R03.1 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
R03.1 is the ICD-10-CM diagnosis code for nonspecific low blood-pressure reading. A blood pressure reading that is lower than normal during a medical visit without a confirmed diagnosis of hypotension. R03.1 sits in the ICD-10-CM chapter for symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (r00-r99), within the section covering symptoms and signs involving the circulatory and respiratory systems (r00-r09).
R03.1 is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.
Document the actual blood pressure values and any associated symptoms (dizziness, weakness) in the record.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for R03.1 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Document the actual blood pressure values and any associated symptoms (dizziness, weakness) in the record
- •Use this code for isolated low readings; if chronic hypotension is diagnosed, use the appropriate hypotension code