R07.81 ICD-10-CM Code: Pleurodynia
HCC Buddy Code Card
Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.
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)
R07.81
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidancePleurodynia
Pleurodynia is sharp chest pain caused by inflammation of the pleura (the membrane surrounding the lungs), often triggered by breathing or coughing.
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
Official- Pleurodynia NOS
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for R07.81 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for R07.81 in this effective period.
Excludes 1
Official- epidemic pleurodynia (B33.0)
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for R07.81 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for R07.81 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for R07.81 in this effective period.
Buddy Documentation Tip
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.
Is R07.81 an HCC code?
No. R07.81 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
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
R07.81 is the ICD-10-CM diagnosis code for pleurodynia. Pleurodynia is sharp chest pain caused by inflammation of the pleura (the membrane surrounding the lungs), often triggered by breathing or coughing. R07.81 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).
R07.81 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 underlying cause if known (viral infection, bacterial infection, or other etiology).
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for R07.81 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Document the underlying cause if known (viral infection, bacterial infection, or other etiology)
- •Pleurodynia is often associated with viral infections; consider coding the underlying viral condition if documented
Excludes 1, Do NOT code together
- epidemic pleurodynia (B33.0)