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ICD-10 Guide
ICD-10 CodesR54

R54

Age-related physical debility

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/11/2025

Code Description

ICD-10 R54 is a billable code used to indicate a diagnosis of age-related physical debility.

Key Diagnostic Point:

R54 refers to age-related physical debility, a condition characterized by a decline in physical function and strength associated with aging. This debility may manifest as weakness, fatigue, decreased endurance, and reduced mobility, impacting the individual's ability to perform daily activities. Clinically, it is often observed in older adults who may present with nonspecific symptoms such as generalized weakness, frailty, and increased susceptibility to falls. The condition can be exacerbated by comorbidities such as chronic diseases, malnutrition, and sedentary lifestyle. Laboratory findings may show decreased muscle mass or strength, and clinical assessments may reveal limitations in physical performance. It is essential to differentiate R54 from other conditions that may cause similar symptoms, such as neurological disorders or systemic illnesses, to ensure appropriate management and care.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in presentation among elderly patients
  • Overlap with other diagnoses such as frailty syndrome
  • Need for comprehensive documentation of functional status
  • Potential for misdiagnosis due to nonspecific symptoms

Audit Risk Factors

  • Inadequate documentation of functional impairment
  • Failure to differentiate from other similar codes
  • Lack of supporting clinical evidence for the diagnosis
  • Misuse of the code in younger populations

Specialty Focus

Medical Specialties

Internal Medicine

Documentation Requirements

Detailed documentation of the patient's functional status, comorbidities, and any relevant lab findings.

Common Clinical Scenarios

Patients presenting with fatigue, weakness, and decreased mobility during routine check-ups.

Billing Considerations

Consideration of polypharmacy and its impact on physical debility.

Emergency Medicine

Documentation Requirements

Acute care documentation must include a thorough assessment of the patient's physical capabilities and any acute exacerbations of debility.

Common Clinical Scenarios

Elderly patients presenting after falls or with acute weakness.

Billing Considerations

Rapid assessment of underlying causes of debility in acute settings.

Coding Guidelines

Inclusion Criteria

Use R54 When
  • According to ICD
  • 10 guidelines, R54 should be used when age
  • related physical debility is the primary diagnosis, and it is essential to document the clinical context and any contributing factors

Exclusion Criteria

Do NOT use R54 When
No specific exclusions found.

Related CPT Codes

99406CPT Code

Smoking and tobacco use cessation counseling visit

Clinical Scenario

Used for counseling elderly patients on lifestyle changes to improve physical debility.

Documentation Requirements

Document the counseling session details and patient response.

Specialty Considerations

Internal medicine may focus on comprehensive lifestyle assessments.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of age-related conditions, improving the ability to capture the nuances of physical debility in older adults.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of age-related conditions, improving the ability to capture the nuances of physical debility in older adults.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of age-related conditions, improving the ability to capture the nuances of physical debility in older adults.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

When should R54 be used?

R54 should be used when a patient presents with age-related physical debility, characterized by weakness and decreased functional capacity, and when no other specific diagnosis explains these symptoms.