Alphabetic Index FY2027

R78

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

FY2027Chapter 18: Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified/R70–R79 Abnormal findings on examination of blood, without diagnosis

Non-billable headerNot valid on its own. Use one of the more specific codes under it.

R78 is a non-billable ICD-10-CM code category for findings of drugs and other substances, not normally found in blood. Report a more specific code from it instead. It is part of the FY2027 code set, effective October 1, 2026. The more specific codes under it are R78.0 Finding of alcohol in blood, R78.1 Finding of opiate drug in blood, R78.2 Finding of cocaine in blood, R78.3 Finding of hallucinogen in blood and 6 more. Its coding notes include a Use additional code instruction and 12 Excludes2 entries.

Guidelines tip

From the FY2027 Official Guidelines. ICD10Ref adds no rules of its own.

Symptom and sign codes are acceptable when no definitive diagnosis has been established. They are not added for signs that are routinely associated with a diagnosis.

Guidelines I.C.18.a; I.C.18.bSymptom and sign codesRead the official text

Use additional code

Add the listed code as a secondary code, if known.

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

Excludes2

Not included here. Both codes may be reported if the patient has both conditions.

This code
  • mental or behavioral disorders due to psychoactive substance use (F10-F19)
Also from chapter/block level (11 notes)
Inherited from R70–R79 Abnormal findings on examination of blood, without diagnosis
  • abnormal findings on antenatal screening of mother (O28.-)
  • abnormalities of lipids (E78.-)
  • abnormalities of platelets and thrombocytes (D69.-)
  • abnormalities of white blood cells classified elsewhere (D70-D72)
  • coagulation hemorrhagic disorders (D65-D68)
  • diagnostic abnormal findings classified elsewhere - see Alphabetical Index
  • hemorrhagic and hematological disorders of newborn (P50-P61)
Inherited from Chapter 18 Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified
  • abnormal findings on antenatal screening of mother (O28.-)
  • certain conditions originating in the perinatal period (P04-P96)
  • signs and symptoms classified in the body system chapters
  • signs and symptoms of breast (N63, N64.5)

Notes

Also from chapter/block level (9 notes)
Inherited from Chapter 18 Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified
  • This chapter includes symptoms, signs, abnormal results of clinical or other investigative procedures, and ill-defined conditions regarding which no diagnosis classifiable elsewhere is recorded.
  • Signs and symptoms that point rather definitely to a given diagnosis have been assigned to a category in other chapters of the classification. In general, categories in this chapter include the less well-defined conditions and symptoms that, without the necessary study of the case to establish a final diagnosis, point perhaps equally to two or more diseases or to two or more systems of the body. Practically all categories in the chapter could be designated 'not otherwise specified', 'unknown etiology' or 'transient'. The Alphabetical Index should be consulted to determine which symptoms and signs are to be allocated here and which to other chapters. The residual subcategories, numbered .8, are generally provided for other relevant symptoms that cannot be allocated elsewhere in the classification.
  • The conditions and signs or symptoms included in categories R00-R94 consist of:
    • (a) cases for which no more specific diagnosis can be made even after all the facts bearing on the case have been investigated;
    • (b) signs or symptoms existing at the time of initial encounter that proved to be transient and whose causes could not be determined;
    • (c) provisional diagnosis in a patient who failed to return for further investigation or care;
    • (d) cases referred elsewhere for investigation or treatment before the diagnosis was made;
    • (e) cases in which a more precise diagnosis was not available for any other reason;
    • (f) certain symptoms, for which supplementary information is provided, that represent important problems in medical care in their own right.

More specific codes under R78 10