Is ICD-10-CM code R97 billable?

No, R97 (Abnormal tumor markers) is a non-billable ICD-10-CM code. It must be coded to a more specific subcategory before it can be used for reimbursement.

What chapter does ICD-10-CM code R97 belong to?

R97 belongs to Chapter 18 of the ICD-10-CM tabular list: R00–R99 (Symptoms, Signs and Abnormal Clinical and Laboratory Findings).

R97Not billable, use a more specific code below

Abnormal tumor markers

chapter 18: Symptoms, Signs and Abnormal Clinical and Laboratory Findings

5 billable codes under R97: none are a CC or MCC; none map to an HCC.

Instructional notes

Includes: conditions that are coded here

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

Official coding guidelines

From the ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027 (CMS and NCHS). Links open the PDF at the right page.

Covers when to report symptom, sign, and abnormal finding codes (R00-R99), plus specific rules for falls, coma scales, non-infectious SIRS, death NOS, and NIHSS scores.

Use of symptom codes (page 75)
Use of a symptom code with a definitive diagnosis code (page 75)
Combination codes that include symptoms (page 75)
Repeated falls (page 76)
Coma (page 76)
Functional quadriplegia (page 76)
SIRS due to Non-Infectious Process (page 77)
Death NOS (page 77)

Read Section I.C.18 (page 75), 1 more topics

All codes under R97

R97 can't be used on a claim. Pick a billable code below; grey headings group them.

R97 MS-DRGs

As the principal diagnosis, all 5 billable codes under R97 group to MS-DRG 947 or 948 (v44.0). Which one applies depends on procedures performed, secondary diagnoses (CC/MCC), and the patient's age and discharge status.

Other codes that refer to R97

Notes on these codes point to R97.

R83-R89 Excludes2: abnormal tumor markers (R97.-)

Code history

Valid since FY2016, when ICD-10-CM took effect on October 1, 2015. No changes since.