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R12

Billable

Heartburn

This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).

What This Code Means

A burning sensation in the chest or throat caused by stomach acid backing up into the esophagus, commonly known as acid reflux.

Coding Tips

  • •Heartburn is a symptom; if GERD is diagnosed, use the appropriate GERD code instead
  • •Document whether this is occasional or frequent to support medical necessity

Excludes 1 — Do NOT code together

  • dyspepsia NOS (R10.13)
  • functional dyspepsia (K30)

Code Hierarchy

└R12Heartburn
└R12Heartburn

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