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R07 ICD-10-CM Code: Pain in throat and chest

ICD-10-CM Code View

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)

R07

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

Pain in throat and chest

Pain in throat and chest

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)
R07Pain in throat and chest

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for R07 in this effective period.

Excludes 2

Official
  • jaw pain R68.84
  • pain in breast (N64.4)

Related Child Codes

Official
R07.0Pain in throat
R07.1Chest pain on breathing
R07.2Precordial pain
R07.8Other chest pain
R07.9Chest pain, unspecified

Includes

Official

ICD-10-CM does not list Includes notes for R07 in this effective period.

Excludes 1

Official
  • epidemic myalgia (B33.0)

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for R07 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for R07 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for R07 in this effective period.

Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.

Coder workflow notes

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What This Code Means

R07 is the ICD-10-CM diagnosis code for pain in throat and chest. R07 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 R07 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 R07'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 R07 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Excludes 1, Do NOT code together

Excludes 2, Not included here, may code separately

Child Codes

Code Hierarchy

R07Pain in throat and chest
R07Pain in throat and chest

Work R07 in HCC Buddy

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