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v1.0.0
ICD-10 Guide
ICD-10 CodesR04

R04

Hemorrhage from respiratory passages

BILLABLE STATUSNo
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/05/2025

Code Description

ICD-10 R04 is a used to indicate a diagnosis of hemorrhage from respiratory passages.

Key Diagnostic Point:

The ICD-10 Level 1 Category code R04 pertains to hemorrhage from respiratory passages, which encompasses various conditions characterized by bleeding originating from the respiratory tract. This category includes but is not limited to epistaxis (nosebleeds), hemoptysis (coughing up blood), and other forms of respiratory bleeding. Clinically, these conditions can range from benign to life-threatening, necessitating prompt diagnosis and intervention. The presence of hemorrhage in the respiratory passages may indicate underlying issues such as infections, trauma, malignancies, or vascular abnormalities, making accurate coding essential for appropriate treatment and management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of potential underlying causes
  • Need for precise documentation
  • Differentiation from other bleeding disorders

Audit Risk Factors

  • Inadequate documentation of the cause
  • Misclassification of the type of hemorrhage
  • Failure to specify the site of bleeding

Specialty Focus

Medical Specialties

Pulmonology

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Emergency Medicine

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Related Codes

Child Codes

7 codes
R04.0
Epistaxis
R04.1
Hemorrhage from throat
R04.2
Hemoptysis
R04.8
Hemorrhage from other sites in respiratory passages
R04.81
Acute idiopathic pulmonary hemorrhage in infants
R04.89
Hemorrhage from other sites in respiratory passages
R04.9
Hemorrhage from respiratory passages, unspecified

Related CPT Codes

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The clinical and administrative impact of the R04 code category is significant, as it plays a crucial role in monitoring and managing respiratory health issues within populations. Accurate coding of hemorrhage from respiratory passages can influence quality measures, patient outcomes, and healthcare trends, particularly in identifying at-risk populations and implementing preventive strategies. Furthermore, as healthcare systems increasingly focus on value-based care, understanding the implications of respiratory hemorrhage on overall patient health can guide resource allocation and improve care delivery.

ICD-9 vs ICD-10

The clinical and administrative impact of the R04 code category is significant, as it plays a crucial role in monitoring and managing respiratory health issues within populations. Accurate coding of hemorrhage from respiratory passages can influence quality measures, patient outcomes, and healthcare trends, particularly in identifying at-risk populations and implementing preventive strategies. Furthermore, as healthcare systems increasingly focus on value-based care, understanding the implications of respiratory hemorrhage on overall patient health can guide resource allocation and improve care delivery.

Reimbursement & Billing Impact

reimbursement. Providers should ensure that all relevant clinical information is captured in the medical record, including the patient's history, examination findings, and any diagnostic tests performed. Accurate coding is essential not only for reimbursement but also for tracking healthcare outcomes and quality measures related to respiratory health. Additionally, understanding payer-specific guidelines is crucial, as different insurers may have varying requirements for documentation and coding related to respiratory hemorrhage.

Resources

Clinical References

  • •
    Official ICD-10 Guidelines for R04

Coding & Billing References

  • •
    Official ICD-10 Guidelines for R04

Frequently Asked Questions

What conditions are included in R04?

Conditions included in R04 encompass epistaxis, hemoptysis, and other forms of bleeding from the respiratory tract, which may arise from various etiologies such as infections, trauma, or malignancies.

When should I use R04 codes?

R04 codes should be used when documenting cases of hemorrhage originating from the respiratory passages, particularly when the bleeding is significant enough to warrant medical attention or intervention.

What documentation is required for R04?

Documentation for R04 should include detailed clinical notes describing the nature of the hemorrhage, the site of bleeding, any underlying conditions, and the treatment provided to ensure accurate coding and reimbursement.