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ICD-10-CM R68.12: Fussy infant (baby)

R68.12 is the billable ICD-10-CM code for fussy infant (baby), in category R68 (Other general symptoms and signs) of the General symptoms and signs section. As a principal diagnosis it groups to MS-DRG 947 Signs and Symptoms with MCC, MS-DRG 948 Signs and Symptoms without MCC (MDC 23 MDC 23: Factors Influencing Health Status and Other Contacts with Health Services).

Compiled from CMS files by the QuickIntell RCM Editorial Team · Data effective · Method: reference methodology · Report a data correction

Data currency: ICD-10-CM code descriptions: FY2027 (effective October 1, 2026); IPPS Table 5 (MS-DRG weights): v44 FY2027 (final rule + CN3) (effective October 1, 2026); ICD-10-CM to HCC mapping: PY2027 initial ICD-10-CM mappings (dates of service 2026) (payment year 2027); Medicare Coverage Database billing and coding articles: MCD release October 8, 2026 (effective October 4, 2026). Next CMS release: FY2028 code files, effective October 1, 2027 for the ICD-10-CM code descriptions; FY2028 final rule (August 2027), effective October 1, 2027; an April 1 interim grouper update when CMS issues one for the IPPS Table 5 (MS-DRG weights); PY2028 advance notice (February 2027) and the PY2027 midyear final mapping (spring 2027) for the ICD-10-CM to HCC mapping; weekly, every Thursday for the Medicare Coverage Database billing and coding articles.

Code
R68.12
billable FY2027 ICD-10-CM code
Category
R68 Other general symptoms and signs
Chapter
18: Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99)
CC/MCC (MS-DRG v44)
Neither
CMS-HCC V28
Not mapped
POA reporting
Required

Tabular list notes for R68.12

The tabular list has no notes on R68.12 itself; the notes below apply from its parent headings.

Inherited from R68.1 (Nonspecific symptoms peculiar to infancy)

Excludes1 (never coded together)
  • colic, infantile (R10.83)
  • neonatal cerebral irritability (P91.3)
  • teething syndrome (K00.7)

MS-DRG grouping when R68.12 is the principal diagnosis

MS-DRG v44 groups for R68.12 as principal diagnosis
MDCMS-DRGs
23 MDC 23: Factors Influencing Health Status and Other Contacts with Health Services947948

The final group also depends on procedures, secondary diagnoses and discharge status; the MS-DRG lookup for R68.12 shows the full grouping logic.

CC/MCC status and inpatient edits

R68.12 is neither a CC nor an MCC under MS-DRG v44, so as a secondary diagnosis it does not raise the MS-DRG severity level. Check R68.12 against a principal diagnosis.

  • Present on admission: a POA indicator is required on inpatient claims.
  • Medicare Code Editor: age conflict: pediatric diagnosis (age 0 to 17).

CMS-HCC V28 risk adjustment

R68.12 does not map to a payment HCC in the PY2027 CMS-HCC V28 model, so on its own it does not change a Medicare Advantage risk score.

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Frequently asked questions

What does ICD-10-CM R68.12 mean?

R68.12 means fussy infant (baby). It is one of 12 billable codes under R68, other general symptoms and signs.

What can't be coded with R68.12?

Excludes1 at R68.1: colic, infantile (R10.83); neonatal cerebral irritability (P91.3); teething syndrome (K00.7). These are never reported together with R68.12.

Which MS-DRG does R68.12 group to?

As the principal diagnosis, R68.12 groups to MS-DRG 947 Signs and Symptoms with MCC, MS-DRG 948 Signs and Symptoms without MCC (MDC 23 MDC 23: Factors Influencing Health Status and Other Contacts with Health Services) under MS-DRG v44, before procedures and secondary diagnoses are applied.

Sources

Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-10. Verify against the primary file before billing or contracting decisions. The reference methodology explains how each figure is computed from these files.

Disclaimer

The descriptor and notes are reproduced from the FY2027 ICD-10-CM files; MS-DRG, CC/MCC and HCC facts come from the CMS FY2027 and PY2027 tables. Code from the medical record and the ICD-10-CM Official Guidelines. Not legal, clinical or billing advice.

Found a figure that does not match the CMS file? Report a data correction with the CMS file and the value you expected; the request reaches the editorial team through the contact form.