R11.0 ICD-10-CM Code: Nausea
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 digestive system and abdomen (R10-R19)
R11.0
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceNausea
The sensation of needing to vomit or feeling sick to the stomach, without actually 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
Inclusion Terms
Official- Nausea NOS
- Nausea without vomiting
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for R11.0 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for R11.0 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
OfficialICD-10-CM does not list Code First sequencing instructions for R11.0 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for R11.0 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for R11.0 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 R11.0 an HCC code?
No. R11.0 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
- Code
- R11.0
- Description
- Nausea
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF
- —
- Billable
- Yes
- Payment year
- 2026
Coder workflow notes
Get the V28 RAF + MEAT cheat sheet
One printable page: confirm a code's V28 HCC status, its RAF weight, and the MEAT your note needs to make it stick. Free, no card.
Free PDF. No card. Unsubscribe anytime.
This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
R11.0 is the ICD-10-CM diagnosis code for nausea. The sensation of needing to vomit or feeling sick to the stomach, without actually vomiting. R11.0 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).
R11.0 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.
Nausea is often a symptom of other conditions; investigate and code the underlying cause if identified.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for R11.0 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Nausea is often a symptom of other conditions; investigate and code the underlying cause if identified
- •Do not use this code if vomiting has already occurred; use R11.10 or more specific vomiting codes instead