R12 — Heartburn
Is R12 billable?
Yes — R12 is billable for FY2027. R12 is a valid, billable ICD-10-CM code at the highest level of specificity in its branch. R12 may be submitted for encounters from October 1, 2026 through September 30, 2027.
R12 at a glance
| Code | R12 |
|---|---|
| Description | Heartburn |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
Which MS-DRGs does R12 group to?
R12 sits in MDC 06 and helps define the logic of 2 MS-DRGs (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.
- 391Esophagitis, Gastroenteritis and Miscellaneous Digestive Disorders with MCCmedical
- 392Esophagitis, Gastroenteritis and Miscellaneous Digestive Disorders without MCCmedical
How is R12 listed in the Alphabetic Index?
These are the routes through the Alphabetic Index that lead to R12. They show the wording a clinician may have documented, which often differs from the Tabular description.
- Brash (water)
- Heartburn
- Pyrosis
- Waterbrash
Excludes1 — never code together
The conditions below can never be reported together with R12 on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.
- functional dyspepsia (K30)
Excludes2 — not included here
The conditions below are not part of R12, but a patient may have both at the same time. When documentation supports it, R12 and the excluded code may both be reported.
- dyspepsia NOS (R10.13)
Excludes2 — not included here — inherited from Chapter 18
The conditions below are not part of R12, but a patient may have both at the same time. When documentation supports it, R12 and the excluded code may both be reported.
Excludes2 — not included here — inherited from R10-R19
The conditions below are not part of R12, but a patient may have both at the same time. When documentation supports it, R12 and the excluded code may both be reported.
- congenital or infantile pylorospasm (Q40.0)
- gastrointestinal hemorrhage (K92.0-K92.2)
- intestinal obstruction (K56.-)
- newborn gastrointestinal hemorrhage (P54.0-P54.3)
- newborn intestinal obstruction (P76.-)
- pylorospasm (K31.3)
- signs and symptoms involving the urinary system (R30-R39)
- symptoms referable to female genital organs (N94.-)
- symptoms referable to male genital organs (N48-N50)
How long has R12 existed?
R12 has been in ICD-10-CM since at least FY2016, the earliest fiscal year on record here.
Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.
Which codes are confused with R12?
ICD-10-CM declares these codes mutually exclusive with R12 — exactly one of each pair can be correct for a given encounter.