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v1.0.0
ICD-10 Guide
DiagnosesSyncope

Syncope

ICD-10 Coding for Syncope(R55, I95.1)

PRIMARY SPECIALTYCardiology
COMPLEXITYHigh
LAST UPDATED09/15/2025
Sam Tuffun, PT, DPT
Physical Therapist | Medical Coding & Billing Contributor

Diagnosis Overview

What is Syncope?
Essential facts and insights about Syncope

Key Clinical Considerations:

  • Transient loss of consciousness
  • Postural changes, such as standing or sitting
  • Possible prodromal symptoms like dizziness or lightheadedness

Clinical Information

Clinical Criteria & Documentation Requirements

  • Patient history including syncopal episodes and triggers
  • Detailed description of the event and recovery
  • Assessment of risk factors and comorbidities

Coding Guidelines

Usage Guidelines & Examples

  • Use R55 for general syncope; consider G45.9 for transient ischemic attacks.
  • Common errors include misclassifying syncope as seizures or other neurological events.

Code Exclusions

Important Exclusions

  • Seizure disorders
  • Hypoglycemia
  • Orthostatic hypotension

Related ICD-10 Codes

Primary Codes
R55
Syncope and collapse
G45.9
Transient cerebral ischemic attack, unspecified
Differential Codes
I95.1
I44.2
R55
R55
if orthostatic hypotension is ruled out.

Related CPT Codes

CPT codes will be available in a future update.

Specialty Focus

Primary Specialty

Cardiology

Specialty Applications

  • Adults and elderly patients with cardiovascular risk factors
  • Emergency departments, outpatient cardiology clinics, and inpatient settings

Coding Complexity

High Complexity

This diagnosis requires careful attention to:

  • Comprehensive clinical documentation
  • Accurate code selection based on clinical criteria
  • Proper exclusion considerations
  • Specialty-specific coding guidelines

Documentation

Documentation Templates

Billing Information

Billing Considerations

  • Ensure proper documentation for billing
  • Verify code specificity requirements
  • Check for any additional codes needed
  • Review payer-specific guidelines

Common Issues

  • Insufficient clinical documentation
  • Incorrect code selection
  • Missing supporting diagnoses
  • Timing and frequency documentation

Frequently Asked Questions

Documentation requirements?

Include detailed patient history, event description, and any diagnostic tests performed.

Billing considerations?

Ensure accurate coding based on the type of syncope and associated conditions.