R29.2 ICD-10-CM Code: Abnormal reflex
Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.
Coding at a Glance
- Tabular directives
- 3 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 R29.2 in the official ICD-10-CM tabular list, quoted as published.
Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2026Effective: October 1, 2025
Excludes2 — Not Included Here
Conditions not covered by this code, but which may be reported alongside it when both are present.
- abnormal pupillary reflex (H57.0) Compare R29.2 vs H57.0 →
- hyperactive gag reflex (J39.2) Compare R29.2 vs J39.2 →
- vasovagal reaction or syncope (R55) Compare R29.2 vs R55 →
Coder workflow for R29.2
MedCoder structured workflow — derived from this code’s own official record
Before you code R29.2
- 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).
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.
Consider R29.2. 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
Excludes2 — not part of R29.2(3 notes)
Coding workflow: The conditions named in this note are not included in R29.2. 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 R29.2 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).
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 (10)
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 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):SYM010 — Nervous system 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 (Nervous system signs and symptoms).
R26.1 — Paralytic gait, R26.2 — Difficulty in walking, not elsewhere classified, R26.81 — Unsteadiness on feet, R26.89 — Other abnormalities of gait and mobility, R26.9 — Unspecified abnormalities of gait and mobility, R27.0 — Ataxia, unspecified, R27.8 — Other lack of coordination, R27.9 — Unspecified lack of coordination, R29.0 — Tetany, R29.1 — Meningismus, R29.5 — Transient paralysis, R29.810 — Facial weakness, R29.818 — Other symptoms and signs involving the nervous system, R29.90 — Unspecified symptoms and signs involving the nervous system, R40.2110 — Coma scale, eyes open, never, unspecified time, R40.2111 — Coma scale, eyes open, never, in the field [EMT or ambulance], R40.2112 — Coma scale, eyes open, never, at arrival to emergency department, R40.2113 — Coma scale, eyes open, never, at hospital admission, R40.2114 — Coma scale, eyes open, never, 24 hours or more after hospital admission, R40.2120 — Coma scale, eyes open, to pain, unspecified time, +138 more
Same Index main term, other category
The ICD-10-CM Index to Diseases and Injuries files this code under the main terms “Poor”, “Abnormal, abnormality, abnormalities”, “Disturbance”, …; these codes share that main term but sit in a different category of the Tabular List.
R20.3 — Hyperesthesia (sensation NEC, skin, hyperesthesia), R20.8 — Other disturbances of skin sensation (temperature, sense), R20.9 — Unspecified disturbances of skin sensation (sensation NEC), R25.0 — Abnormal head movements (head movement), R25.1 — Tremor, unspecified (movement, involuntary, tremor), R25.2 — Cramp and spasm (movement, involuntary, spasm), R25.3 — Fasciculation (movement, involuntary, fasciculation), R25.8 — Other abnormal involuntary movements (movement, involuntary, specified type NEC), R25.9 — Unspecified abnormal involuntary movements (movement, involuntary), R27.8 — Other lack of coordination (coordination), R39.12 — Poor urinary stream (urinary stream), R39.198 — Other difficulties with micturition (urination NEC), R42 — Dizziness and giddiness (equilibrium), R43.0 — Anosmia (sensation NEC, smell, anosmia), R43.1 — Parosmia (olfactory nerve), R43.2 — Parageusia (sensation NEC, taste, parageusia), R43.8 — Other disturbances of smell and taste (sensation NEC, smell, and taste), R43.9 — Unspecified disturbances of smell and taste (sensation NEC, taste), R45.0 — Nervousness (nervous, functional), R46.0 — Very low level of personal hygiene (personal hygiene), +396 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 R29.2 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 R29.2 with these 3 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
- H57.0 — Anomalies of pupillary function[Excludes2]: “abnormal pupillary reflex (H57.0)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- J39.2 — Other diseases of pharynx[Excludes2]: “hyperactive gag reflex (J39.2)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- R55 — Syncope and collapse[Excludes2]: “vasovagal reaction or syncope (R55)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
Clinical classification (CCSR)
- SYM010 — Nervous system 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 (10)
- Abnormal, abnormality, abnormalities, knee jerk[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
- Abnormal, abnormality, abnormalities, plantar reflex[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
- Areflexia[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
- Disorder (of), reflex[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
- Disturbance (s), motor[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
- Disturbance (s), reflex[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
- Hyper-reflexia[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
- Hyporeflexia[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
- and 2 more
Nearest codes (40)
- R29 — Other symptoms and signs involving the nervous and musculoskeletal systems[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- R29.0 — Tetany[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- R29.1 — Meningismus[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- R29.3 — Abnormal posture[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- R29.4 — Clicking hip[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- R29.5 — Transient paralysis[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- R29.6 — Repeated falls[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- R29.7 — National Institutes of Health Stroke Scale (NIHSS) score[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- and 32 more
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. "R29.2 — Abnormal reflex." ICD-10-CM FY2026. https://medcoder.ai/icd10/code/r29.2-abnormal-reflex
Change history
- FY2016 — October 1, 2015In the code set at ICD-10-CM adoptionAbnormal reflex
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 R29.2 in its code family, with their registry titles.
- R29 — Other symptoms and signs involving the nervous and musculoskeletal systems
- R29.0 — Tetany
- R29.1 — Meningismus
- R29.3 — Abnormal posture
- R29.4 — Clicking hip
- R29.5 — Transient paralysis
- R29.6 — Repeated falls
- R29.7 — National Institutes of Health Stroke Scale (NIHSS) score
- R29.70 — NIHSS score 0-9
- R29.700 — NIHSS score 0