Diagnosis Code ICD-10-CM Guidelines and Definition for Shortness of Breath
Shortness of breath—also known as dyspnea—is one of the most common symptoms reported in medical practice. Whether it’s a patient gasping after mild exertion or someone struggling to breathe during pregnancy, accurate documentation and billing matter more than ever. If you’re looking for the correct ICD 10 code for shortness of breath, this guide is for you.
At Express Medical Billing, we’ve worked closely with providers across the U.S. to reduce denials and ensure clean claims using the correct diagnosis codes. Let’s break down everything you need to know—from unspecified SOB to shortness of breath in newborns.
Understanding Shortness of Breath in ICD-10
The primary ICD-10 code use for shortness of breath is R06.02. This is the go-to code for general or unspecified cases of dyspnea when no other specific cause is yet identified.
- SOB ICD 10
- ICD 10 SOB
Common ICD-10 Codes for SOB-Related Conditions
Here’s a list of the most frequently used ICD-10 codes associated with shortness of breath:
Condition | ICD-10 Code | Description |
Shortness of breath (unspecified) | R06.02 | General SOB |
Dyspnea on exertion | R06.09 | SOB during physical activity |
Cough | R05 | Common in respiratory disorders |
Chest pain | R07.9 | When SOB occurs with chest pain |
Wheezing | R06.2 | Often seen in asthma or bronchitis |
Respiratory suffering – newborn | P22.9 | For infant breathing problems |
Respiratory suffering – child | J96.90 | Acute or chronic cases |
SOB with hypoxia | R09.02 | SOB linked to low oxygen |
SOB in pregnancy | O99.8 | Use trimester-specific codes |
Real-World Scenarios - How to Choose the Right Code
Case 1: Shortness of Breath on Mild Exertion
A 55-year-old patient reports breathlessness after climbing stairs. No known cardiac or pulmonary disease.
Correct Code: R06.09 – Dyspnea on exertion ICD 10
Case 2: Infant with Breathing Difficulty
A newborn is admitted with respiratory distress but no clear diagnosis yet.
Exact Code: P22.9 – ICD 10 code for respiratory suffering newborn
Case 3: Third Trimester Pregnancy with SOB
A pregnant woman in her third trimester reports shortness of breath.
Correct Code: O99.8 and Z3A.38 – ICD 10 code for shortness of breath in pregnancy third trimester
Why Accurate Coding Matters
Use the correct ICD 10 code for shortness of breath:
- Prevents costly denials
- Improves claim approval rates
- Reflects accurate patient care
- Supports future audits and data reporting
Need Help with Respiratory Claim Denials?
At Express Medical Billing, we help healthcare providers:
- choose the right ICD 10 codes for SOB
- Avoid denials due to vague diagnoses
- Stay compliant with payer-specific documentation
Explore our Medical Coding Services | Physician Billing Services | Denial Management
Final Thoughts
Choosing the right ICD 10 code for shortness of breath can seem simple—but it’s often not. With overlapping symptoms, various patient types, and payer-specific rules, the small stuff matters. Whether you’re billing for dyspnea on exertion, a pregnancy case, or pediatric respiratory distress, specificity is your secret weapon.
Need expert help? Let’s simplify your billing. Call us today at (727) 440-5903 or visit Express Medical Billing.
Frequently Asked Questions (FAQs)
ICD-10 code R06.02 is commonly used to document general shortness of breath when there’s no specific underlying cause identified.
For shortness of breath that occurs specifically during exertion, the correct ICD-10 code is R06.09. This should be used when physical activity or movement triggers the symptom.
To document shortness of breath in a pregnant patient, use O99.8 in combination with the appropriate trimester code (e.g., Z3A.38 for 38 weeks). It's important to note the gestational age for billing accuracy.
Yes. When symptoms like shortness of breath, cough, or chest pain are present together, you can report multiple codes such as R06.02 for SOB, R05 for cough, and R07.9 for unspecified chest pain as long as the documentation supports them.
In newborns with respiratory distress, the code P22.9 should be used for unspecified respiratory issues. If an additional specific cause is identified, update the code to replicate that diagnosis.
Using specific codes, like R06.09 for exceptional dyspnea or R09.02 for hypoxia, helps ensure billing accuracy, reduces claim rejections, and better represents clinical care. Avoid using unspecified codes unless absolutely necessary.
