R39.85 ICD-10-CM Code: Costovertebral (angle) tenderness

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for R39.85 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2026Effective: October 1, 2025

Coder workflow for R39.85

MedCoder structured workflow — derived from this code’s own official record

Before you code R39.85

1. R39.85 is not reportable as written. Select the more specific code beneath it that the documentation supports. Codes are reported to the highest level of specificity the classification provides (Guidelines I.B.2).

   ReviewR39.851, R39.852, R39.853, R39.859

   See the relationships section · Guide: How to choose an ICD-10-CM code →

2. Check whether an established diagnosis that explains this sign or symptom is documented. If one is, review whether the documented diagnosis changes the coding pathway: a symptom that is integral to a confirmed diagnosis is not reported separately, while one not routinely associated with it may be. Signs and symptoms are reported when no definitive diagnosis is established (Guidelines I.B.4, I.B.5, I.B.6, I.C.18.b).

   Guide: Symptom code vs confirmed diagnosis →

Choose the right path

1. Does the documentation support one of the more specific codes beneath R39.85?
   Yes → Select that code and continue the checks below on its own page.
   No → R39.85 cannot be reported as written; query for the specificity its subcategory needs.

   ReviewR39.851, R39.852, R39.853, R39.859

2. Is an established diagnosis that explains this sign or symptom documented?
   Yes → Review whether the documented diagnosis changes the coding pathway: a symptom integral to it is not reported separately.
   No → Continue — the sign or symptom code stands when no definitive diagnosis is established.

Consider R39.85. Then confirm the code is valid for the date of service in the Verify section.

Documentation check

The provider’s diagnostic statement

Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).

Official instructions as workflow

• Excludes2 — not part of R39.85(1 note)

  Coding workflow: The conditions named in this note are not included in R39.85. When the record documents both, both may be reported; the note is a boundary, not a prohibition.

  CompareR10

  See the official tabular notes · Guidelines I.A.12.b

Coding decision scenarios

Pattern scenarios for this code’s structure — decision rules, not clinical cases

Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.

Don’t confuse R39.85 with…

MedCoder analysis — pairs from this code’s official notes, distinctions written by MedCoder

The codes most likely to be picked instead of R39.85 — named in its own official notes, or sharing its laterality or encounter family — with what separates them and which documentation moves the case. Each links to the full comparison.

• R10— Excludes2 relationship (Informational)

  Distinct conditions — both may be reported.

  A distinct condition — both may be reported when both are documented.

  What moves you there: Documentation of abdominal and pelvic pain adds R10; it is not part of this code and both may be reported when both are documented.

  Full comparison: R39.85 vs R10 →

Relationships are read from this code's own official notes, its laterality siblings and its encounter family; the wording of each distinction is MedCoder editorial, and the documentation named in each “what moves you there” line is the official note phrase or sibling title itself. Source: CMS ICD-10-CM tabular instructional notes; ICD-10-CM Official Guidelines, Section I.A.12.a.

Verify Before Coding

• Not billable as written — a more specific code is required: R39.851, R39.852, R39.853, R39.859.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.

Relationships & Classification

MedCoder structured relationships — computed from published CMS and AHRQ datasets

Other codes that name R39.85 or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.

Referenced by 12 Excludes2 notes: R10 — Abdominal and pelvic pain (via R39.-), R10 — Abdominal and pelvic pain, R10-R19 — Symptoms and signs involving the digestive system and abdomen (R10-R19) (via R39.-), R11 — Nausea and vomiting (via R39.-), R12 — Heartburn (via R39.-), R13 — Aphagia and dysphagia (via R39.-), R14 — Flatulence and related conditions (via R39.-), R15 — Fecal incontinence (via R39.-), R16 — Hepatomegaly and splenomegaly, not elsewhere classified (via R39.-), R17 — Unspecified jaundice (via R39.-), R18 — Ascites (via R39.-), R19 — Other symptoms and signs involving the digestive system and abdomen (via R39.-).

These codes’ tabular lists name this diagnosis as distinct — both may be reported when both are documented.

Contextual Map

Every relationship of R39.85 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Run R39.85 with these 7 related codes in Claim Check

Hierarchy

• R00-R99 — Chapter 18: Symptoms, Signs and Abnormal Clinical and Laboratory Findings, Not Elsewhere Classified (R00-R99) (R00-R99)[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• R30-R39 — Symptoms and signs involving the genitourinary system[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026

Excludes2

• R10 — Abdominal and pelvic pain[Excludes2]: “abdominal and pelvic pain (R10.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026

Referenced by Excludes2 notes (12)

• R10 — Abdominal and pelvic pain[Excludes2](via R39.-): “signs and symptoms involving the urinary system (R30-R39)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• R10 — Abdominal and pelvic pain[Excludes2]: “costovertebral (angle) tenderness (R39.85)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• R10-R19 — Symptoms and signs involving the digestive system and abdomen (R10-R19)[Excludes2](via R39.-): “signs and symptoms involving the urinary system (R30-R39)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• R11 — Nausea and vomiting[Excludes2](via R39.-): “signs and symptoms involving the urinary system (R30-R39)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• R12 — Heartburn[Excludes2](via R39.-): “signs and symptoms involving the urinary system (R30-R39)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• R13 — Aphagia and dysphagia[Excludes2](via R39.-): “signs and symptoms involving the urinary system (R30-R39)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• R14 — Flatulence and related conditions[Excludes2](via R39.-): “signs and symptoms involving the urinary system (R30-R39)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• R15 — Fecal incontinence[Excludes2](via R39.-): “signs and symptoms involving the urinary system (R30-R39)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• and 4 more

Nearest codes (25)

• R39 — Other and unspecified symptoms and signs involving the genitourinary system[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• R39.0 — Extravasation of urine[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• R39.1 — Other difficulties with micturition[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• R39.11 — Hesitancy of micturition[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• R39.12 — Poor urinary stream[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• R39.13 — Splitting of urinary stream[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• R39.14 — Feeling of incomplete bladder emptying[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• R39.15 — Urgency of urination[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• and 17 more

Change history

• FY2026 — Added to the code set[Change history]— CMS release files (code change ledger) · icd10cm-fy2026

Common coding questions

Sources for this page

Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.

Code, title, tabular notes and index terms Official source data

CMS/CDC ICD-10-CM FY2026 tabular list, index and tables, effective October 1, 2025 Release, file and checksum · Publisher’s page

Claim edits Official source data

CMS Definitions of Medicare Code Edits — v43.1 (April 2026) Release, file and checksum · Publisher’s page

Change history and date-of-service validity Official source data

CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page

Comparisons, relationships and the contextual map MedCoder structured relationship

Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears

Summary and FAQ answers MedCoder explanation

Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.

Labels on this page: Official source data · MedCoder structured relationship · MedCoder explanation. How to read the labels · All data sources and release dates

Nearest Codes in This Family

Official ICD-10-CM classifications closest to R39.85 in its code family, with their registry titles.

• R39.8 — Other symptoms and signs involving the genitourinary system
• R39.81 — Functional urinary incontinence
• R39.82 — Chronic bladder pain
• R39.83 — Unilateral non-palpable testicle
• R39.84 — Bilateral non-palpable testicles
• R39.851 — Costovertebral (angle) tenderness, right side
• R39.852 — Costovertebral (angle) tenderness, left side
• R39.853 — Costovertebral (angle) tenderness, bilateral
• R39.859 — Costovertebral (angle) tenderness, unspecified side
• R39.89 — Other symptoms and signs involving the genitourinary system

View all codes in the R39 family