All ICD10 Codes

R97

Non-Billable
ChapterR00–R99
Rankcategory
Official Description

Abnormal tumor markers

Use a more specific code (3 billable, 1 non-billable)
R97.0Elevated carcinoembryonic antigen [CEA]R97.1Elevated cancer antigen 125 [CA 125]R97.2Elevated prostate specific antigen [PSA]has subcodesR97.8Other abnormal tumor markers
Metadata & Insights
  • •Non-billable category (requires more specific sub-code).
  • •Chapter 18: Symptoms, Signs and Abnormal Clinical and Laboratory Findings (R00-R99).

CH18 Parent Instructions

Excludes2(Not included here. Code separately if applicable.)
  • abnormal findings on antenatal screening of mother (O28.-)
  • certain conditions originating in the perinatal period (P04-P96)
  • signs and symptoms classified in the body system chapters
  • signs and symptoms of breast (N63, N64.5)

Instructional Notes

Includes
  • Elevated tumor associated antigens [TAA]
  • Elevated tumor specific antigens [TSA]

Clinical Hierarchy

BillableHas subcodes
CH18Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99)
R97Abnormal tumor markersNot billable
R97.0Elevated carcinoembryonic antigen [CEA]Billable
R97.1Elevated cancer antigen 125 [CA 125]Billable
R97.2Elevated prostate specific antigen [PSA]Subcodes
R97.8Other abnormal tumor markersBillable

Applicable Ancestor Context

The following parent sections contain instructions or notes that apply to R97:

chapterCH18
Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99)
View context instructions

MS-DRG Classification

2026

No direct MS-DRG triggers identified.

Cross Reference

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