R42 – Dizziness and giddiness

Billable/ Specific Code:

R42 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.

Applicable to:

• Light-headedness
• Vertigo NOS

Approximate Synonyms:

• Chronic vertigo
• Disembarkment syndrome
• Dizziness
• Dysequilibrium
• Dysequilibrium syndrome
• Light headedness
• Lightheadedness
• Mal dedebarquement syndrome
• Non-labyrinth vertigo
• Non-labyrinthine vertigo
• Vertigo
• Vertigo (spinning sensation)
• Vertigo (spinning sensation), chronic
• Vertigo as late effect of embolic cerebrovascular accident
• Vertigo as late effect of hemorrhagic cerebrovascular accident
• Vertigo as late effect of ischemic cerebrovascular accident
• Vertigo as sequela of cerebrovascular disease
• Vertigo from stroke
• Vertigo, late effect of cerebrovascular disease

Clinical Information

• A disorder characterized by a sensation as if the external world were revolving around the patient (objective vertigo) or as if he himself were revolving in space (subjective vertigo).
• An illusion of movement, either of the external world revolving around the individual or of the individual revolving in space. Vertigo may be associated with disorders of the inner ear (ear, inner); vestibular nerve; brainstem; or cerebral cortex. Lesions in the temporal lobe and parietal lobe may be associated with focal seizures that may feature vertigo as an ictal manifestation. (from Adams et al., Principles of Neurology, 6th ed, pp300-1)
• Illusory sense that either the environment or one’s own body is revolving; may result from disease of the inner ear or disturbances of the vestibular centers or pathways.
• Vertigo is a feeling of movement, a sensation as if the external world were revolving around the patient (objective vertigo) or as if he himself were revolving in space (subjective vertigo). Vertigo is medically distinct from dizziness, lightheadedness, and unsteadiness.

ICD-10: A Brief Synopsis

For disease reporting, the US utilizes its own national variant of ICD-10 called the ICD-10 Clinical Modification (ICD-10-CM). A procedural classification called ICD-10 Procedure Coding System (ICD-10-PCS) has also been developed for capturing inpatient procedures. The ICD-10-CM and ICD-10-PCS were developed by the Centers for Medicare and Medicaid Services (CMS) and the National Center for Health Statistics (NCHS). There are over 70,000 ICD-10-PCS procedure codes and over 69,000 ICD-10-CM diagnosis codes, compared to about 3,800 procedure codes and roughly 14,000 diagnosis codes found in the previous ICD-9-CM.

The expansion of healthcare delivery systems and changes in global health trends prompted a need for codes with improved clinical accuracy and specificity. The alphanumeric coding in ICD-10 is an improvement from ICD-9 which had a limited number of codes and a restrictive structure. Early concerns in the implementation of ICD-10 included the cost and the availability of resources for training healthcare workers and professional coders.

There was much controversy when the transition from the ICD-9-CM to the ICD-10-CM was first announced in the US. Many providers were concerned about the vast number of codes being added, the complexity of the new coding system, and the costs associated with the transition. The Centers for Medicare and Medicaid Services (CMS) weighed these concerns against the benefits of having more accurate data collection, clearer documentation of diagnoses and procedures, and more accurate claims processing. CMS decided the financial and public health cost associated with continuing to use the ICD-9-CM was too high and mandated the switch to ICD-10-CM.