DxCodebookFY2027 · Oct 1, 2026 – Sep 30, 2027

Category · FY2027

R78 Findings of drugs and other substances, not normally found in blood

  • Header · not billable

R78 is not billable. The category heads 13 billable codes in FY2027, grouped under 10 subdivisions.

FY2027 changes under R78: 1 billable code added. All FY2027 changes.

Index → code

  • Bacteremia → R78.81
  • Bloodconstituents, abnormal → R78.9
  • Excess, excessive, excessivelyalcohol level in blood → R78.0

Where it sits

  1. Chapter 18 Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99)
  2. R70-R79 Abnormal findings on examination of blood, without diagnosis (R70-R79)
  3. R78 Findings of drugs and other substances, not normally found in blood
Billable codes
13
Subdivisions
10
CC / MCC codes
1 / 0
HCC V28 codes
0
New FY2027
1
Index entries
21

Codes in R78

  1. R78.0
    Finding of alcohol in blood
    Billable
    Use additional code 1

    Use additional code

    • external cause code (Y90.-), for detail regarding alcohol level. Y90
  2. R78.1
    Finding of opiate drug in blood
    Billable
  3. R78.2
    Finding of cocaine in blood
    Billable
  4. R78.3
    Finding of hallucinogen in blood
    Billable
  5. R78.4
    Finding of other drugs of addictive potential in blood
    Billable
  6. R78.5
    Finding of other psychotropic drug in blood
    Billable
  7. R78.6
    Finding of steroid agent in blood
    Billable
  8. R78.7
    Finding of abnormal level of heavy metals in blood
    Header
  9. R78.71
    Abnormal lead level in blood
    Billable
    Excludes1 1

    Excludes1

    • lead poisoning (T56.0-) T56.0
  10. R78.72
    Abnormal gadolinium level in blood New FY2027
    Billable
    Excludes1 1

    Excludes1

    • toxic effect of gadolinium (T56.82-) T56.82
  11. R78.79
    Finding of abnormal level of heavy metals in blood
    Billable
  12. R78.8
    Finding of other specified substances, not normally found in blood
    Header
  13. R78.81
    Bacteremia
    BillableCC
    Excludes1 1

    Excludes1

    • sepsis-code to specified infection
  14. R78.89
    Finding of other specified substances, not normally found in blood
    Billable
    Inclusion terms 1

    Inclusion terms

    • Finding of abnormal level of lithium in blood
  15. R78.9
    Finding of unspecified substance, not normally found in blood
    Billable

CC/MCC: as a secondary diagnosis, unless the principal diagnosis is on the code’s PDX exclusion list (MS-DRG v44 Appendix C; list on the code card).

Sources of each column.

Instructions

At R78

Excludes2

  • mental or behavioral disorders due to psychoactive substance use (F10-F19) F10 F19

Use additional code

  • code to identify any retained foreign body, if applicable (Z18.-) Z18

Notes that also apply

Block R70-R79 instructions (Excludes2 7): printed on the block page.

Chapter 18 instructions (Notes 9, Excludes2 4): printed on the chapter 18 page.

Index entries

  • Bacteremia → R78.81
  • Excess, excessive, excessivelyalcohol level in blood → R78.0
  • Findings, abnormal, inconclusive, without diagnosisalcohol in blood → R78.0
  • Abnormal, abnormality, abnormalitiestoxicology (findings) → R78.9
  • Bloodconstituents, abnormal → R78.9
  • Findings, abnormal, inconclusive, without diagnosisin blood (of substance not normally found in blood) → R78.9
  • Findings, abnormal, inconclusive, without diagnosisin blood (of substance not normally found in blood)alcohol (excessive level) → R78.0
  • Findings, abnormal, inconclusive, without diagnosisin blood (of substance not normally found in blood)opiate drug → R78.1
  • Findings, abnormal, inconclusive, without diagnosisin blood (of substance not normally found in blood)cocaine → R78.2
  • Findings, abnormal, inconclusive, without diagnosisin blood (of substance not normally found in blood)hallucinogen → R78.3
  • Findings, abnormal, inconclusive, without diagnosisin blood (of substance not normally found in blood)addictive drug NEC → R78.4
  • Findings, abnormal, inconclusive, without diagnosisin blood (of substance not normally found in blood)psychotropic drug → R78.5
  • Findings, abnormal, inconclusive, without diagnosisin blood (of substance not normally found in blood)steroid agent → R78.6
  • Findings, abnormal, inconclusive, without diagnosisin blood (of substance not normally found in blood)lead → R78.71
  • Findings, abnormal, inconclusive, without diagnosisin blood (of substance not normally found in blood)gadolinium level → R78.72
  • Findings, abnormal, inconclusive, without diagnosisin blood (of substance not normally found in blood)heavy metals (abnormal level) → R78.79
  • Findings, abnormal, inconclusive, without diagnosiscultureblood → R78.81
  • Positiveculture (nonspecific)blood → R78.81
  • Abnormal, abnormality, abnormalitiesblood level (of)lithium → R78.89
  • Findings, abnormal, inconclusive, without diagnosisin blood (of substance not normally found in blood)lithium (abnormal level) → R78.89
  • Findings, abnormal, inconclusive, without diagnosisin blood (of substance not normally found in blood)specified substance NEC → R78.89

NCHS Alphabetic Index. Index first, then the Tabular List.

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