2025 ICD-10-CM code R99
Ill-defined and unknown cause of mortality. This code encompasses death where the cause cannot be determined.
Code R99 is used when a more specific cause of death cannot be determined. It is essential to document the efforts made to establish a definitive diagnosis and the reasons why a more specific code is not applicable.
Clinicians are responsible for ensuring that all available information is used to determine the cause of death before assigning code R99. This may involve consulting with other specialists, reviewing medical records, and ordering additional tests if necessary.Accurate documentation is crucial for legal and statistical purposes.
In simple words: This code means the cause of death is unknown or unclear, even after investigation.
This code is used when the cause of death cannot be determined even after all available information, such as investigative findings and medical history, has been reviewed. It includes cases where a more specific diagnosis was not possible due to various reasons, including transient symptoms, incomplete investigations, or referral elsewhere before a definitive diagnosis could be made.
Example 1: A patient dies suddenly and unexpectedly at home. An autopsy is performed, but no definitive cause of death is found., A patient with a history of multiple health problems dies in the hospital. Despite extensive testing and treatment, the exact cause of death remains undetermined., A patient is brought to the emergency room unconscious and dies shortly after.Despite resuscitation efforts and initial investigations, the cause of death cannot be immediately ascertained, and further investigation yields no definitive diagnosis.
Documentation should include all relevant clinical findings, diagnostic test results, autopsy reports (if available), and any other information that was considered in determining the cause of death. The rationale for using R99 should also be clearly documented.
** As of today, December 1st, 2024, R99 is the correct code to report an ill-defined and unknown cause of mortality. Coding guidelines and regulations are subject to change, it's important to stay up-to-date with the latest information from authoritative sources like the WHO and CMS.
- Specialties:Forensic pathologists, general practitioners, hospitalists, and other medical specialists who may be involved in determining the cause of death.
- Place of Service:Inpatient Hospital, Emergency Room - Hospital, Hospice, Home, Other Place of Service.