R19.6
BillableHalitosis
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is R19.6 an HCC code?
No. R19.6 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
R19.6 is the ICD-10-CM diagnosis code for halitosis. Bad breath or foul-smelling breath that may indicate poor oral hygiene, dental disease, or underlying systemic health issues. R19.6 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).
R19.6 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 whether the halitosis is persistent or intermittent and any associated oral or systemic symptoms.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for R19.6 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Document whether the halitosis is persistent or intermittent and any associated oral or systemic symptoms
- •Consider investigating for underlying causes such as periodontal disease, gastroesophageal reflux, or respiratory infections