R62.7: Adult failure to thrive
R62.7, adult failure to thrive, is listed as a covered diagnosis in 3 Medicare billing and coding articles that apply to 9 HCPCS Level II codes, including G0299 (Direct skilled nursing services of a registered nurse (rn)…), G0300 (Direct skilled nursing services of a licensed practical…), G0283 (Electrical stimulation (unattended), to one or more areas…). The articles come from 1 Medicare contractor. 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 R62.7 as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| G0299 | Direct skilled nursing services of a registered nurse (rn) in the home health or hospice setting, each 15 minutes | Carrier judgment | — | 1 |
| G0300 | Direct skilled nursing services of a licensed practical nurse (lpn) in the home health or hospice setting, each 15 minutes | Carrier judgment | — | 1 |
| G0283 | Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care | Carrier judgment | — | 2 |
| G0152 | Services performed by a qualified occupational therapist in the home health or hospice setting, each 15 minutes | Carrier judgment | — | 1 |
| G0158 | Services performed by a qualified occupational therapist assistant in the home health or hospice setting, each 15 minutes | Carrier judgment | — | 1 |
| G0160 | Services performed by a qualified occupational therapist, in the home health setting, in the establishment or delivery of a safe and effective occupational therapy maintenance program, each 15 minutes | Carrier judgment | — | 1 |
| G2169 | Services performed by an occupational therapist assistant in the home health setting in the delivery of a safe and effective occupational therapy maintenance program, each 15 minutes | Carrier judgment | — | 1 |
| G0281 | Electrical stimulation, (unattended), to one or more areas, for chronic stage iii and stage iv pressure ulcers, arterial ulcers, diabetic ulcers, and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care, as part of a therapy plan of care | Carrier judgment | — | 1 |
| G0329 | Electromagnetic therapy, to one or more areas for chronic stage iii and stage iv pressure ulcers, arterial ulcers, diabetic ulcers and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care as part of a therapy plan of care | Carrier judgment | — | 1 |
Medicare policy articles listing R62.7
- A56679: Billing and Coding: Hospice The Adult Failure To Thrive Syndrome (Palmetto GBA (HHH MAC); 2 Level II codes). LCD with the same title: L34558
- A53057: Billing and Coding: Home Health Occupational Therapy (Palmetto GBA (HHH MAC); 5 Level II codes). LCD with the same title: L34560
- A53064: Billing and Coding: Outpatient Occupational Therapy (Palmetto GBA (MAC - Part A); 3 Level II codes). LCD with the same title: L34427
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.
Frequently asked questions
Does Medicare cover R62.7 (Adult failure to thrive)?
Medicare covers items and services, not diagnoses. 3 Medicare billing and coding articles list R62.7 as a covered diagnosis for 9 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 R62.7?
The Level II codes from the policies most specific to this diagnosis are G0299 (Direct skilled nursing services of a registered nurse (rn)…, 1 article); G0300 (Direct skilled nursing services of a licensed practical…, 1 article); G0283 (Electrical stimulation (unattended), to one or more areas…, 2 articles); G0152 (Services performed by a qualified occupational therapist…, 1 article); G0158 (Services performed by a qualified occupational therapist…, 1 article). Code choice depends on the item supplied; check each code's descriptor.
Which Medicare policy articles list R62.7?
A56679 (Billing and Coding: Hospice The Adult Failure To Thrive Syndrome); A53057 (Billing and Coding: Home Health Occupational Therapy); A53064 (Billing and Coding: Outpatient Occupational Therapy).
What is ICD-10-CM code R62.7?
R62.7 is the ICD-10-CM code for adult failure to thrive, in category R62 (Lack of expected normal physiological development in childhood and adults), chapter 18: Symptoms, signs and abnormal findings.
Next steps
- Run a reimbursement report for a device billed under G0299
- Watch G0299 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for G0299
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