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Compare/R86 vs R97

R86 vs R97

R86 (Abnormal findings in specimens from male genital organs) compared with R97 (Abnormal tumor markers), from the official CMS tabular data. Both may be reported when both conditions are documented (Excludes2).

Can these codes be reported together?

Yes, when both are documented. R86 carries an Excludes2 note covering R97: “abnormal tumor markers (R97.-)”

Excludes2 marks distinct conditions — both may be reported when both are documented.

Side by side

R86Abnormal findings in specimens from male genital organsR97Abnormal tumor markers
Billing statusNon-billable header

Report instead: R86.0, R86.1, R86.2, R86.3, R86.4

Non-billable header

Report instead: R97.0, R97.1, R97.20, R97.21, R97.8

ClassificationR00-R99 — Symptoms, Signs and Abnormal Clinical and Laboratory Findings, Not Elsewhere Classified (R00-R99)R00-R99 — Symptoms, Signs and Abnormal Clinical and Laboratory Findings, Not Elsewhere Classified (R00-R99)
DefinitionAbnormal findings in specimens from male genital organs is a non-billable ICD-10-CM category code (R86).Abnormal tumor markers is a non-billable ICD-10-CM category code (R97).
Includes
abnormal findings in prostatic secretions
abnormal findings in semen, seminal fluid
abnormal spermatozoa
Elevated tumor associated antigens [TAA]
Elevated tumor specific antigens [TSA]

Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources