R00.2 ICD-10-CM Code: Palpitations
Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.
Coding at a Glance
- Tabular directives
- 1 inclusion term · 1 Excludes1 · 1 Excludes2
Inpatient Payment Groups (MS-DRG)
Potential MS-DRG participation — not a DRG assignment.
MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v43, Appendix B.
- MS-DRG 308 — CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC (MDC 05)
- MS-DRG 309 — CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC (MDC 05)
- MS-DRG 310 — CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC (MDC 05)
A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.
Coding instructions
Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for R00.2 in the official ICD-10-CM tabular list, quoted as published.
Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2026Effective: October 1, 2025
Notes without a marker are published on R00.2 itself; “inherited from” names the category or block whose note applies here.
Inclusion Terms
Alternative terms the tabular list files under this code.
- Awareness of heart beat
Excludes1 — Not Coded Here
Conditions generally not reported together with this code (Excludes1) -- an error unless the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).
- abnormalities originating in the perinatal period (P29.1-) Compare R00.2 vs P29.1 →
Source: inherited from R00
Excludes2 — Not Included Here
Conditions not covered by this code, but which may be reported alongside it when both are present.
- specified arrhythmias (I47-I49) Compare R00.2 vs I47 →
Source: inherited from R00
Coder workflow for R00.2
MedCoder structured workflow — derived from this code’s own official record
Before you code R00.2
- Check whether an established diagnosis that explains this sign or symptom is documented. If one is, review whether the documented diagnosis changes the coding pathway: a symptom that is integral to a confirmed diagnosis is not reported separately, while one not routinely associated with it may be. Signs and symptoms are reported when no definitive diagnosis is established (Guidelines I.B.4, I.B.5, I.B.6, I.C.18.b).
- Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with R00.2. Excludes1 conditions are not reported together with this code unless the record shows they are unrelated (Guidelines I.A.12.a).
Choose the right path
- Is an established diagnosis that explains this sign or symptom documented?
Yes → Review whether the documented diagnosis changes the coding pathway: a symptom integral to it is not reported separately.
No → Continue — the sign or symptom code stands when no definitive diagnosis is established. - Does the documentation support a condition named in R00.2’s Excludes1 note?
Yes → Do not simply proceed: review the excluded code. Both are reported only when the record shows the two conditions are unrelated.
No → Continue.ReviewP29.1
Consider R00.2. Then confirm the code is valid for the date of service in the Verify section.
Documentation check
- The provider’s diagnostic statement
- Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).
Official instructions as workflow
Excludes1 — check before selecting R00.2(1 note)
Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with R00.2: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.
CompareP29.1
See the official tabular notes · Guidelines I.A.12.a
Excludes2 — not part of R00.2(1 note)
Coding workflow: The conditions named in this note are not included in R00.2. When the record documents both, both may be reported; the note is a boundary, not a prohibition.
See the official tabular notes · Guidelines I.A.12.b
Coding decision scenarios
Pattern scenarios for this code’s structure — decision rules, not clinical cases
Documentation: The sign or symptom is documented, and the same record establishes a diagnosis that routinely includes it.
Coding question: Is R00.2 reported in addition to the diagnosis?
Path: Review the documented diagnosis and whether the classification treats this finding as integral to it.
Reason: Signs and symptoms integral to a confirmed diagnosis are not coded separately; those not routinely associated with it may be reported when present (Guidelines I.B.5, I.B.6, I.C.18.b).
Documentation: Both the condition R00.2 describes and a condition named in its Excludes1 note are documented for the same encounter.
Coding question: Can both codes be reported?
Path: Review the Excludes1 note and the excluded code, and look for a provider statement on whether the two conditions are related.
Reason: Excludes1 means the two are not coded together; the exception is when the record shows the conditions are unrelated to each other (Guidelines I.A.12.a).
ReviewP29.1
Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.
Code Overview
MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.
Indexed Clinical Terms (4)
Official source data — entries quoted as published, in the Index’s own lookup phrasing
Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code. These are alphabetic-index entries shown as the Index writes them — lookup phrasing, not necessarily the wording of a final diagnosis.
Verify Before Coding
- No Medicare Code Editor or MS-DRG Definitions Manual restrictions apply to this code.
From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.
Relationships & Classification
MedCoder structured relationships — computed from published CMS and AHRQ datasets
MS-DRG Grouper Relationships (FY2026)
Potential MS-DRG participation — not a DRG assignment.
FY2026 MS-DRG: not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity for that release.
Named in the grouper logic of 3 MS-DRGs: DRG 308 (MDC 05), DRG 309 (MDC 05), DRG 310 (MDC 05).
From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.
Clinical classification (AHRQ CCSR):SYM012 — Circulatory signs and symptoms (default).
Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.
Related Codes
Same clinical category (CCSR)
AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Circulatory signs and symptoms).
R00.0 — Tachycardia, unspecified, R00.1 — Bradycardia, unspecified, R00.8 — Other abnormalities of heart beat, R00.9 — Unspecified abnormalities of heart beat, R01.0 — Benign and innocent cardiac murmurs, R01.1 — Cardiac murmur, unspecified, R01.2 — Other cardiac sounds, R03.0 — Elevated blood-pressure reading, without diagnosis of hypertension, R03.1 — Nonspecific low blood-pressure reading, R09.89 — Other specified symptoms and signs involving the circulatory and respiratory systems, R58 — Hemorrhage, not elsewhere classified
Same Index main term, other category
The ICD-10-CM Index to Diseases and Injuries files this code under the main term “Abnormal, abnormality, abnormalities”; these codes share that main term but sit in a different category of the Tabular List.
Q93.2 — Chromosome replaced with ring, dicentric or isochromosome (chromosome, chromosomal, ring replacement), Q95.5 — Individual with autosomal fragile site (autosomes, fragile site), Q97.1 — Female with more than three X chromosomes (chromosome, chromosomal, with more than three X chromosomes, female), Q97.8 — Other specified sex chromosome abnormalities, female phenotype (chromosome, chromosomal, sex, female phenotype, specified NEC), Q97.9 — Sex chromosome abnormality, female phenotype, unspecified (chromosome, chromosomal, sex, female phenotype), Q98.6 — Male with structurally abnormal sex chromosome (chromosome, chromosomal, sex, structural male), Q98.8 — Other specified sex chromosome abnormalities, male phenotype (chromosome, chromosomal, sex, male phenotype, specified NEC), Q98.9 — Sex chromosome abnormality, male phenotype, unspecified (chromosome, chromosomal, sex, male phenotype), Q99.8 — Other specified chromosome abnormalities (chromosome, chromosomal, sex), Q99.9 — Chromosomal abnormality, unspecified (autosomes), R01.2 — Other cardiac sounds (heart, sounds NEC), R03.0 — Elevated blood-pressure reading, without diagnosis of hypertension (blood pressure, elevated), R03.1 — Nonspecific low blood-pressure reading (blood pressure, low reading), R06.9 — Unspecified abnormalities of breathing (breathing), R09.3 — Abnormal sputum (sputum), R09.89 — Other specified symptoms and signs involving the circulatory and respiratory systems (chest sounds), R19.11 — Absent bowel sounds (bowel sounds, absent), R19.12 — Hyperactive bowel sounds (bowel sounds, hyperactive), R19.15 — Other abnormal bowel sounds (bowel sounds), R19.5 — Other fecal abnormalities (feces), +239 more
Lab tests where this diagnosis supports Medicare coverage (NCD)
Medicare's National Coverage Determination (NCD) program lists this diagnosis as medical justification for these lab tests.
Contextual Map
Every relationship of R00.2 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.
Hierarchy
- R00-R99 — Chapter 18: Symptoms, Signs and Abnormal Clinical and Laboratory Findings, Not Elsewhere Classified (R00-R99) (R00-R99)[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- R00-R09 — Symptoms and signs involving the circulatory and respiratory systems[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
Clinical classification (CCSR)
- SYM012 — Circulatory signs and symptoms[CCSR]— AHRQ CCSR for ICD-10-CM Diagnoses (HCUP)
MS-DRG Grouper
- DRG 308 — CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC[MS-DRG]: “CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC (MDC 05)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026
- DRG 309 — CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC[MS-DRG]: “CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC (MDC 05)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026
- DRG 310 — CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC[MS-DRG]: “CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC (MDC 05)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026
MDC crossing
- MDC 05 — Diseases and Disorders of the Circulatory System[MDC crossing]: “Diseases and Disorders of the Circulatory System — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs. 17,209 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2026
Index entries
- Abnormal, abnormality, abnormalities, pulsations in neck[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
- Awareness of heart beat[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
- Heart beat, awareness[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
- Palpitations (heart)[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
Nearest codes
- R00 — Abnormalities of heart beat[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- R00.0 — Tachycardia, unspecified[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- R00.1 — Bradycardia, unspecified[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- R00.8 — Other abnormalities of heart beat[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- R00.9 — Unspecified abnormalities of heart beat[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
Change history
- FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016
Sources for this page
Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.
- Code, title, tabular notes and index terms Official source data
- CMS/CDC ICD-10-CM FY2026 tabular list, index and tables, effective October 1, 2025 Release, file and checksum · Publisher’s page
- Claim edits Official source data
- CMS Definitions of Medicare Code Edits — v43.1 (April 2026) Release, file and checksum · Publisher’s page
- Inpatient payment groups Official source data
- CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v43 Release, file and checksum · Publisher’s page
- Change history and date-of-service validity Official source data
- CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page
- Comparisons, relationships and the contextual map MedCoder structured relationship
- Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
- Summary and FAQ answers MedCoder explanation
- Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.
Labels on this page: Official source data · MedCoder structured relationship · MedCoder explanation. How to read the labels · All data sources and release dates
Cite this page
Reference this page in a research guide, syllabus or article. The release is included because code content changes each year.
MedCoder.ai. "R00.2 — Palpitations." ICD-10-CM FY2026. https://medcoder.ai/icd10/code/r00.2-palpitations
Change history
- FY2016 — October 1, 2015In the code set at ICD-10-CM adoptionPalpitations
No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027 (effective October 1, 2026), and none are recorded for this code. Note changes are tracked from FY2027 only.
Nearest Codes in This Family
Official ICD-10-CM classifications closest to R00.2 in its code family, with their registry titles.