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R11 ICD-10-CM Code: Nausea and vomiting

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 digestive system and abdomen (R10-R19)

R11

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

Nausea and vomiting

Nausea and vomiting

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
R1Symptoms and signs involving the digestive system and abdomen (R10-R19)
R11Nausea and vomiting

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for R11 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for R11 in this effective period.

Related Child Codes

Official
R11.0Nausea
R11.1Vomiting
R11.2Nausea with vomiting, unspecified

Includes

Official

ICD-10-CM does not list Includes notes for R11 in this effective period.

Excludes 1

Official
  • cyclical vomiting associated with migraine (G43.A-)
  • excessive vomiting in pregnancy (O21.-)
  • hematemesis (K92.0)
  • neonatal hematemesis (P54.0)
  • newborn vomiting (P92.0-)

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for R11 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for R11 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for R11 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
R11
Description
Nausea and vomiting
HCC (V28)
No CMS-HCC V28 mapping
RAF
Billable
No
Payment year
2026

Coder workflow notes

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What This Code Means

R11 is the ICD-10-CM diagnosis code for nausea and vomiting. R11 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 digestive system and abdomen (r10-r19).

Header codes like R11 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 R11'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 R11 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Excludes 1, Do NOT code together

  • cyclical vomiting associated with migraine (G43.A-)
  • excessive vomiting in pregnancy (O21.-)
  • hematemesis (K92.0)
  • neonatal hematemesis (P54.0)
  • newborn vomiting (P92.0-)
  • psychogenic vomiting (F50.89)
  • vomiting associated with bulimia nervosa (F50.2-)
  • vomiting following gastrointestinal surgery (K91.0)

Child Codes

Code Hierarchy

R11Nausea and vomiting
R11Nausea and vomiting

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