R56 ICD-10-CM Code: Convulsions, not elsewhere classified
R56 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · HCC coding software
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FY 2026 Apr update / Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99) / General symptoms and signs (R50-R69)
R56
Header CodeICD-10-CMOfficial ICD-10-CMCodebook guidanceConvulsions, not elsewhere classified
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
OfficialNo inclusion terms are included in this display for R56. Check the code and parent instructions in the Code Book.
Excludes 2
Official- abnormal findings on antenatal screening of mother (O28.-)Inherited from R00-R99
- certain conditions originating in the perinatal period (P04-P96)Inherited from R00-R99
- signs and symptoms classified in the body system chaptersInherited from R00-R99
- signs and symptoms of breast (N63, N64.5)Inherited from R00-R99
Related Codes
Includes
OfficialNo Includes notes are included in this display for R56. Check the code and parent instructions in the Code Book.
Excludes 1
Official- dissociative convulsions and seizures (F44.5)
- epileptic convulsions and seizures (G40.-)
- newborn convulsions and seizures (P90)
Code First
OfficialNo Code First sequencing instructions are included in this display for R56. Check the code and parent instructions in the Code Book.
Use Additional
OfficialNo Use Additional Code instructions are included in this display for R56. Check the code and parent instructions in the Code Book.
Code Also
OfficialNo Code Also instructions are included in this display for R56. Check the code and parent instructions in the Code Book.
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
- R56
- Description
- Convulsions, not elsewhere classified
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF reference coefficient
- —
- Billable
- No
- Payment year
- 2026
Coder workflow notes
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What This Code Means
R56 is the ICD-10-CM diagnosis code for convulsions, not elsewhere classified. R56 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 general symptoms and signs (r50-r69).
Header codes like R56 cannot be reported on claims directly; they organize child codes that share clinical context. Coders should select the billable child code that matches the documented presentation and then verify its current source-backed HCC mapping. Do not infer a child code or risk adjustment value from the header alone.
HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for R56 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.