R57
Non-Billable (Header)Shock, not elsewhere classified
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
What This Code Means
R57 is the ICD-10-CM diagnosis code for shock, not elsewhere classified. R57 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 R57 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 R57'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 R57 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Excludes 1 — Do NOT code together
- anaphylactic shock NOS (T78.2)
- anaphylactic reaction or shock due to adverse food reaction (T78.0-)
- anaphylactic shock due to adverse effect of correct drug or medicament properly administered (T88.6)
- anaphylactic shock due to serum (T80.5-)
- electric shock (T75.4)
- obstetric shock (O75.1)
- postprocedural shock (T81.1-)
- psychic shock (F43.0)
- shock complicating or following ectopic or molar pregnancy (O00-O07, O08.3)
- shock due to anesthesia (T88.2)
- shock due to lightning (T75.01)
- traumatic shock (T79.4)
- toxic shock syndrome (A48.3)