ICD-10 · PDGM grouping
R78 Findings of drugs and other substances, not normally found in blood
All 13 codes in the R78 family, with the PDGM clinical group, comorbidity subgroup and primary-position rule CMS assigns, read from the CMS grouper crosswalk v07.2.26 and the CDC FY2027 code file.
Codes in family
13
Can lead a claim
0
Cannot lead a claim
13
What CMS assigns to R78
None of the 13 codes is assigned a clinical group. None of the 13 is assigned a comorbidity subgroup. None can lead a claim.
Every code in R78
Descriptions are CDC’s FY2027 wording; where CMS’s grouper abbreviates one, its form is shown beneath.
| Code | Description | Primary position | Clinical group | Comorbidity subgroup |
|---|---|---|---|---|
| R78.0 | Finding of alcohol in blood | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| R78.1 | Finding of opiate drug in blood | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| R78.2 | Finding of cocaine in blood | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| R78.3 | Finding of hallucinogen in blood | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| R78.4 | Finding of other drugs of addictive potential in blood | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| R78.5 | Finding of other psychotropic drug in blood | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| R78.6 | Finding of steroid agent in blood | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| R78.7 Finding of abnormal level of heavy metals in blood | ||||
| R78.71 | Abnormal lead level in blood | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| R78.72 | Abnormal gadolinium level in blood | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| R78.79 | Finding of abnormal level of heavy metals in blood | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| R78.8 Finding of other specified substances, not normally found in blood | ||||
| R78.81 | Bacteremia | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| R78.89 | Finding of other specified substances, not normally found in bloodCMS: Finding of oth substances, not normally found in blood | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| R78.9 | Finding of unspecified substance, not normally found in bloodCMS: Finding of unsp substance, not normally found in blood | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
Sources: CMS HH PPS Grouper Software v07.2.26, effective 2026-10-01, for the clinical group, comorbidity subgroup, code-first conventions and primary-position flags; CDC NCHS ICD-10-CM FY2027 code descriptions for the family title and code wording. This is the crosswalk Medicare runs a claim through. Grouping also depends on admission source, timing, the OASIS functional items and the rest of the diagnosis list.
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