R06.9 ICD-10-CM Code: Unspecified abnormalities of breathing
HCC Buddy Code Card
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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)
R06.9
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceUnspecified abnormalities of breathing
This is a catch-all code for any abnormality of breathing when the specific type has not been identified or documented.
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
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for R06.9 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for R06.9 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for R06.9 in this effective period.
Excludes 1
Official- acute respiratory distress syndrome (J80)
- respiratory arrest (R09.2)
- respiratory arrest of newborn (P28.81)
- respiratory distress syndrome of newborn (P22.-)
- respiratory failure (J96.-)
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for R06.9 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for R06.9 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for R06.9 in this effective period.
Buddy Documentation Tip
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 →
Is R06.9 an HCC code?
No. R06.9 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
- Code
- R06.9
- Description
- Unspecified abnormalities of breathing
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF
- —
- Billable
- Yes
- Payment year
- 2026
Coder workflow notes
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This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
R06.9 is the ICD-10-CM diagnosis code for unspecified abnormalities of breathing. This is a catch-all code for any abnormality of breathing when the specific type has not been identified or documented. R06.9 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).
R06.9 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.
Avoid using this code if a more specific breathing abnormality code can be assigned.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for R06.9 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Avoid using this code if a more specific breathing abnormality code can be assigned
- •Query the provider if additional documentation can clarify the type of breathing abnormality