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R05 ICD-10-CM Code: Cough

R05 is not a CMS-HCC payment code. MEAT criteria · RAF calculator · HCC coding software

ICD-10-CM Code View

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FY 2026 Apr update / Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99) / Symptoms and signs involving the circulatory and respiratory systems (R00-R09)

R05

Header CodeICD-10-CMOfficial ICD-10-CMCodebook guidance

Cough

Cough

CMS-HCC V28

N/A

Not mapped

CMS-HCC V24

N/A

Not mapped

ACA/HHS

N/A

Not mapped

ESRD/PACE

N/A

Not mapped

RXHCC

N/A

Not mapped

Code Book Path

Official
R0Symptoms and signs involving the circulatory and respiratory systems (R00-R09)
R05Cough

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for R05 in this effective period.

Excludes 2

Official
  • cough with hemorrhage (R04.2)

Related Child Codes

Official
R05.1Acute cough
R05.2Subacute cough
R05.3Chronic cough
R05.4Cough syncope
R05.8Other specified cough

Includes

Official

ICD-10-CM does not list Includes notes for R05 in this effective period.

Excludes 1

Official
  • paroxysmal cough due to Bordetella pertussis (A37.0-)
  • smoker's cough (J41.0)

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for R05 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for R05 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for R05 in this effective period.

Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →

Code
R05
Description
Cough
HCC (V28)
No CMS-HCC V28 mapping
RAF
Billable
No
Payment year
2026

Coder workflow notes

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What This Code Means

R05 is the ICD-10-CM diagnosis code for cough. R05 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).

Header codes like R05 cannot be reported on claims directly, they organize child codes that share clinical context but the actual diagnosis must be coded to the highest level of specificity supported by the documentation. Coders should look at R05's child codes and select the one that matches the patient's documented presentation, since payers reject header codes submitted as the primary diagnosis. For risk adjustment workflows, header codes never contribute to a Medicare Advantage member's RAF score on their own; only billable child codes that happen to map to a payment HCC affect risk-adjusted plan payments.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for R05 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Excludes 1, Do NOT code together

  • paroxysmal cough due to Bordetella pertussis (A37.0-)
  • smoker's cough (J41.0)

Excludes 2, Not included here, may code separately

  • cough with hemorrhage (R04.2)

Child Codes

Code Hierarchy

R05Cough
R05Cough

R05 code history

Code setChange
FY2022 (effective Oct 1, 2021)Billability changed (now non-billable header)

Source: official CMS ICD-10-CM order and addenda files, FY2016 through FY2027.

Work R05 in HCC Buddy

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