R45.7: State of emotional shock and stress, unspecified
R45.7, state of emotional shock and stress, unspecified, is listed as a covered diagnosis in 3 Medicare billing and coding articles that apply to 5 HCPCS Level II codes, including G0451 (Development testing, with interpretation and report, per…), G0410 (Group psychotherapy other than of a multiple-family group…), G0017 (Psychotherapy for crisis furnished in an applicable site…). The articles come from 3 Medicare contractors. A listed diagnosis supports medical necessity only; coverage still depends on the LCD's criteria and on documentation in the medical record.
HCPCS Level II codes with R45.7 as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| G0451 | Development testing, with interpretation and report, per standardized instrument form | Carrier judgment | — | 2 |
| G0410 | Group psychotherapy other than of a multiple-family group, in a partial hospitalization or intensive outpatient setting, approximately 45 to 50 minutes | Carrier judgment | — | 1 |
| G0017 | Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); first 60 minutes | Carrier judgment | — | 1 |
| G0018 | Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); each additional 30 minutes (list separately in addition to code for primary service) | Carrier judgment | — | 1 |
| G0411 | Interactive group psychotherapy, in a partial hospitalization or intensive outpatient setting, approximately 45 to 50 minutes | Carrier judgment | — | 1 |
Medicare policy articles listing R45.7
- A57480: Billing and Coding: Psychiatry and Psychology Services (WPS Insurance Corporation (MAC - Part A, MAC - Part B); 4 Level II codes). LCD with the same title: L33632, L34616
- A56937: Billing and Coding: Psychiatry and Psychology Services (Wellpoint Federal (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L33632, L34616
- A57780: Billing and Coding: Psychological and Neuropsychological Tests (First Coast Service Options, Inc. (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L34520
A diagnosis listed as covered in a billing and coding article supports medical necessity for the article's codes; it does not guarantee payment. Coverage depends on the LCD's criteria, the contractor's jurisdiction and documentation in the medical record.
Other R45 diagnoses (Symptoms and signs involving emotional state)
- R45.1 — Restlessness and agitation
- R45.2 — Unhappiness
- R45.5 — Hostility
- R45.6 — Violent behavior
- R45.81 — Low self-esteem
- R45.82 — Worries
- R45.83 — Excessive crying of child, adolescent or adult
- R45.84 — Anhedonia
- R45.850 — Homicidal ideations
- R45.851 — Suicidal ideations
- R45.88 — Nonsuicidal self-harm
Frequently asked questions
Does Medicare cover R45.7 (State of emotional shock and stress, unspecified)?
Medicare covers items and services, not diagnoses. 3 Medicare billing and coding articles list R45.7 as a covered diagnosis for 5 HCPCS Level II codes: the diagnosis can support medical necessity for those codes, but payment still depends on the LCD's coverage criteria and the medical record.
Which HCPCS codes can be billed with ICD-10 R45.7?
The Level II codes from the policies most specific to this diagnosis are G0451 (Development testing, with interpretation and report, per…, 2 articles); G0410 (Group psychotherapy other than of a multiple-family group…, 1 article); G0017 (Psychotherapy for crisis furnished in an applicable site…, 1 article); G0018 (Psychotherapy for crisis furnished in an applicable site…, 1 article); G0411 (Interactive group psychotherapy, in a partial…, 1 article). Code choice depends on the item supplied; check each code's descriptor.
Which Medicare policy articles list R45.7?
A57480 (Billing and Coding: Psychiatry and Psychology Services); A56937 (Billing and Coding: Psychiatry and Psychology Services); A57780 (Billing and Coding: Psychological and Neuropsychological Tests).
What is ICD-10-CM code R45.7?
R45.7 is the ICD-10-CM code for state of emotional shock and stress, unspecified, in category R45 (Symptoms and signs involving emotional state), chapter 18: Symptoms, signs and abnormal findings.
Next steps
- Run a reimbursement report for a device billed under G0451
- Watch G0451 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for G0451
Sources: CMS Medicare Coverage Database billing and coding articles (covered ICD-10 code lists and HCPCS links); ICD-10-CM FY2026; CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule 2026 (non-rural state fees). Not billing or legal advice.
Chapter 18: Symptoms, signs and abnormal findings · All diagnoses · HCPCS lookup