R25.2 ICD-10-CM Code: Cramp and spasm
Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.
Coding at a Glance
- Tabular directives
- 3 Excludes1 · 5 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 091 — OTHER DISORDERS OF NERVOUS SYSTEM WITH MCC (MDC 01)
- MS-DRG 092 — OTHER DISORDERS OF NERVOUS SYSTEM WITH CC (MDC 01)
- MS-DRG 093 — OTHER DISORDERS OF NERVOUS SYSTEM WITHOUT CC/MCC (MDC 01)
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 R25.2 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 R25.2 itself; “inherited from” names the category or block whose note applies here.
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).
- specific movement disorders (G20-G26) Compare R25.2 vs G20 →
- stereotyped movement disorders (F98.4) Compare R25.2 vs F98.4 →
- tic disorders (F95.-) Compare R25.2 vs F95 →
Source: inherited from R25
Excludes2 — Not Included Here
Conditions not covered by this code, but which may be reported alongside it when both are present.
- carpopedal spasm (R29.0) Compare R25.2 vs R29.0 →
- charley-horse (M62.831) Compare R25.2 vs M62.831 →
- infantile spasms (G40.4-) Compare R25.2 vs G40.4 →
- muscle spasm of back (M62.830) Compare R25.2 vs M62.830 →
- muscle spasm of calf (M62.831) Compare R25.2 vs M62.831 →
Coder workflow for R25.2
MedCoder structured workflow — derived from this code’s own official record
Before you code R25.2
- 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 R25.2. 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 R25.2’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.
Consider R25.2. 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 R25.2(3 notes)
Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with R25.2: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.
See the official tabular notes · Guidelines I.A.12.a
Excludes2 — not part of R25.2(5 notes)
Coding workflow: The conditions named in this note are not included in R25.2. When the record documents both, both may be reported; the note is a boundary, not a prohibition.
CompareR29.0, M62.831, G40.4, M62.830
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 R25.2 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 R25.2 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).
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 (7)
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
Other codes that name R25.2 or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.
Referenced by 2 Excludes1 notes across 2 chapters: F98.4 — Stereotyped movement disorders (via R25.-), M62 — Other disorders of muscle.
These codes’ tabular lists mark this diagnosis as mutually exclusive — not reported together unless the conditions are documented as unrelated.
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 091 (MDC 01), DRG 092 (MDC 01), DRG 093 (MDC 01).
From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.
Clinical classification (AHRQ CCSR):SYM016 — Other general 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 (Other general signs and symptoms).
E88.A — Wasting disease (syndrome) due to underlying condition, R29.3 — Abnormal posture, R29.4 — Clicking hip, R29.6 — Repeated falls, R29.890 — Loss of height, R29.891 — Ocular torticollis, R29.898 — Other symptoms and signs involving the musculoskeletal system, R29.91 — Unspecified symptoms and signs involving the musculoskeletal system, R49.0 — Dysphonia, R49.1 — Aphonia, R49.21 — Hypernasality, R49.22 — Hyponasality, R49.8 — Other voice and resonance disorders, R49.9 — Unspecified voice and resonance disorder, R52 — Pain, unspecified, R54 — Age-related physical debility, R59.0 — Localized enlarged lymph nodes, R59.1 — Generalized enlarged lymph nodes, R59.9 — Enlarged lymph nodes, unspecified, R60.0 — Localized edema, +38 more
Same Index main term, other category
The ICD-10-CM Index to Diseases and Injuries files this code under the main terms “Abnormal, abnormality, abnormalities”, “Cramp”, “Spasm, spastic, spasticity”; these codes share that main term but sit in a different category of the Tabular List.
R03.1 — Nonspecific low blood-pressure reading (blood pressure, low reading), R06.6 — Hiccough (diaphragm), 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), R10.83 — Colic (colic), 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 (stool), R29.2 — Abnormal reflex (knee jerk), R29.3 — Abnormal posture (posture), R29.890 — Loss of height (loss of, height), R39.198 — Other difficulties with micturition (urination NEC), R63.2 — Polyphagia (increase in appetite), R63.4 — Abnormal weight loss (loss of, weight), R68.89 — Other general symptoms and signs (clinical findings NEC), R70.1 — Abnormal plasma viscosity (plasma, viscosity), R71.8 — Other abnormality of red blood cells (red blood cell), R73.09 — Other abnormal glucose (blood sugar), +285 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 R25.2 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.
Run R25.2 with these 6 related codes in Claim Check
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
- R25-R29 — Symptoms and signs involving the nervous and musculoskeletal systems[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
Excludes2
- G40.4 — Other generalized epilepsy and epileptic syndromes[Excludes2]: “infantile spasms (G40.4-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- M62.830 — Muscle spasm of back[Excludes2]: “muscle spasm of back (M62.830)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- M62.831 — Muscle spasm of calf[Excludes2]: “charley-horse (M62.831)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- R29.0 — Tetany[Excludes2]: “carpopedal spasm (R29.0)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
Referenced by Excludes1 notes
- F98.4 — Stereotyped movement disorders[Excludes1](via R25.-): “abnormal involuntary movements (R25.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- M62 — Other disorders of muscle[Excludes1]: “cramp and spasm (R25.2)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
Clinical classification (CCSR)
- SYM016 — Other general signs and symptoms[CCSR]— AHRQ CCSR for ICD-10-CM Diagnoses (HCUP)
MS-DRG Grouper
- DRG 091 — OTHER DISORDERS OF NERVOUS SYSTEM WITH MCC[MS-DRG]: “OTHER DISORDERS OF NERVOUS SYSTEM WITH MCC (MDC 01)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026
- DRG 092 — OTHER DISORDERS OF NERVOUS SYSTEM WITH CC[MS-DRG]: “OTHER DISORDERS OF NERVOUS SYSTEM WITH CC (MDC 01)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026
- DRG 093 — OTHER DISORDERS OF NERVOUS SYSTEM WITHOUT CC/MCC[MS-DRG]: “OTHER DISORDERS OF NERVOUS SYSTEM WITHOUT CC/MCC (MDC 01)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026
MDC crossing
- MDC 01 — Diseases and Disorders of the Nervous System[MDC crossing]: “Diseases and Disorders of the Nervous 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. 8,892 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2026
Index entries
- Abnormal, abnormality, abnormalities, movement (disorder), involuntary, spasm[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
- Cramp (s)[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
- Cramp (s), limb NEC (lower) (upper)[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
- Cramp (s), muscle (limb) (general)[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
- Hemispasm (facial)[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
- Spasm, spastic, spasticity (s)[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
- Trismus[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
Nearest codes
- R25 — Abnormal involuntary movements[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- R25.0 — Abnormal head movements[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- R25.1 — Tremor, unspecified[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- R25.3 — Fasciculation[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- R25.8 — Other abnormal involuntary movements[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- R25.9 — Unspecified abnormal involuntary movements[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. "R25.2 — Cramp and spasm." ICD-10-CM FY2026. https://medcoder.ai/icd10/code/r25.2-cramp-and-spasm
Change history
- FY2016 — October 1, 2015In the code set at ICD-10-CM adoptionCramp and spasm
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 R25.2 in its code family, with their registry titles.