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R39.853 ICD-10-CM Code: Costovertebral (angle) tenderness, bilateral

Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Coding at a Glance

Tabular directives
1 Excludes2

Inpatient Payment Groups (MS-DRG)

Potential MS-DRG participation — not a DRG assignment.

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v44, Appendix B.

  • MS-DRG 695 — KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITH MCC (MDC 11)
  • MS-DRG 696 — KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITHOUT MCC (MDC 11)

A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for R39.853 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2027Effective: October 1, 2026

Notes without a marker are published on R39.853 itself; “inherited from” names the category or block whose note applies here.

Excludes2 — Not Included Here

Conditions not covered by this code, but which may be reported alongside it when both are present.

Source: inherited from R39.85

Coder workflow for R39.853

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

Before you code R39.853

  1. 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 →

  2. Laterality is coded in this family. Confirm the side documented — right, left, or bilateral — and select the matching code (this page’s code: bilateral). The unspecified-side code applies only when the record states no side. Laterality is assigned from the documented side; where a bilateral code exists and both sides are documented, it is used instead of two unilateral codes (Guidelines I.B.13).

    See the relationships section · Guide: Laterality coding →

Choose the right path

  1. 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.
  2. Is the side documented?
    Yes → Select the code for the documented side (or the bilateral code when both sides are documented and one exists).
    No → Use the unspecified-side code only when the record states no side; a query is the alternative.

Consider R39.853. 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).
Laterality
Right, left or bilateral as documented; unspecified only when the record states no side (Guidelines I.B.13).

Official instructions as workflow

  • Excludes2 — not part of R39.853(1 note)

    Coding workflow: The conditions named in this note are not included in R39.853. 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

Documentation: The sign or symptom is documented, and the same record establishes a diagnosis that routinely includes it.

Coding question: Is R39.853 reported in addition to the diagnosis?

Path: Review the documented diagnosis and whether the classification treats this finding as integral to it.

Reason: Signs and symptoms integral to a confirmed diagnosis are not coded separately; those not routinely associated with it may be reported when present (Guidelines I.B.5, I.B.6, I.C.18.b).

Documentation: The record documents the condition on one side only.

Coding question: Which code in this family applies?

Path: Select the sibling code for the documented side.

Reason: Laterality is assigned from the documented side; the unspecified-side code is for records that state no side (Guidelines I.B.13).

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.

Code Overview

Costovertebral (angle) tenderness, bilateral is a billable ICD-10-CM diagnosis code (R39.853).

MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.

Indexed Clinical Terms (1)

Official source data — entries quoted as published, in the Index’s own lookup phrasing

Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code. These are alphabetic-index entries shown as the Index writes them — lookup phrasing, not necessarily the wording of a final diagnosis.

Verify Before Coding

  • No Medicare Code Editor or MS-DRG Definitions Manual restrictions apply to this code.

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 R39.853 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 11 Excludes2 notes: R10 — Abdominal and pelvic pain (via R39.-), 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.

MS-DRG Grouper Relationships (FY2027)

Potential MS-DRG participation — not a DRG assignment.

FY2027 MS-DRG: not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity for that release.

Named in the grouper logic of 2 MS-DRGs: DRG 695 (MDC 11), DRG 696 (MDC 11).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Clinical classification (AHRQ CCSR):SYM011 — Genitourinary signs and symptoms (default).

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Related Codes

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Genitourinary signs and symptoms).

R39.19 — Other difficulties with micturition, R39.191 — Need to immediately re-void, R39.192 — Position dependent micturition, R39.198 — Other difficulties with micturition, R39.2 — Extrarenal uremia, 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, R39.859 — Costovertebral (angle) tenderness, unspecified side, R39.89 — Other symptoms and signs involving the genitourinary system, R39.9 — Unspecified symptoms and signs involving the genitourinary system, R82.0 — Chyluria, R82.1 — Myoglobinuria, R82.2 — Biliuria, R82.3 — Hemoglobinuria, R82.4 — Acetonuria, R82.5 — Elevated urine levels of drugs, medicaments and biological substances, R82.6 — Abnormal urine levels of substances chiefly nonmedicinal as to source, +38 more

Same Index main term, other category

The ICD-10-CM Index to Diseases and Injuries files this code under the main term “Tenderness, abdominal”; these codes share that main term but sit in a different category of the Tabular List.

R10.811 — Right upper quadrant abdominal tenderness (right upper quadrant), R10.812 — Left upper quadrant abdominal tenderness (left upper quadrant), R10.813 — Right lower quadrant abdominal tenderness (right lower quadrant), R10.814 — Left lower quadrant abdominal tenderness (left lower quadrant), R10.815 — Periumbilic abdominal tenderness (periumbilic), R10.816 — Epigastric abdominal tenderness (epigastric), R10.817 — Generalized abdominal tenderness (generalized), R10.819 — Abdominal tenderness, unspecified site, R10.821 — Right upper quadrant rebound abdominal tenderness (rebound, right upper quadrant), R10.822 — Left upper quadrant rebound abdominal tenderness (rebound, left upper quadrant), R10.823 — Right lower quadrant rebound abdominal tenderness (rebound, right lower quadrant), R10.824 — Left lower quadrant rebound abdominal tenderness (rebound, left lower quadrant), R10.825 — Periumbilic rebound abdominal tenderness (rebound, periumbilic), R10.826 — Epigastric rebound abdominal tenderness (rebound, epigastric), R10.827 — Generalized rebound abdominal tenderness (rebound, generalized), R10.829 — Rebound abdominal tenderness, unspecified site (rebound), R10.8A1 — Right flank tenderness (flank, right), R10.8A2 — Left flank tenderness (flank, left), R10.8A3 — Suprapubic tenderness (suprapubic), R10.8A9 — Flank tenderness, unspecified (flank)

Contextual Map

Every relationship of R39.853 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 R39.853 with these 8 related codes in Claim Check

Hierarchy

Referenced by Excludes2 notes (11)

Clinical classification (CCSR)

MS-DRG Grouper

MDC crossing

  • MDC 11 — Diseases and Disorders of the Kidney and Urinary Tract[MDC crossing]: “Diseases and Disorders of the Kidney and Urinary Tract — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs. 3,578 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2027

Index entries

  • Tenderness, abdominal, costovertebral (angle), bilateral[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026

Nearest codes (25)

Change history

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 FY2027 tabular list, index and tables, effective October 1, 2026 Release, file and checksum · Publisher’s page
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v44.0 (October 2026) Release, file and checksum · Publisher’s page
Inpatient payment groups Official source data
CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v44 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

Cite this page

Reference this page in a research guide, syllabus or article. The release is included because code content changes each year.

MedCoder.ai. "R39.853 — Costovertebral (angle) tenderness, bilateral." ICD-10-CM FY2027. https://medcoder.ai/icd10/code/r39.853-costovertebral-angle-tenderness-bilateral

Change history

  • FY2026 — October 1, 2025
    Added to the code set
    Costovertebral (angle) tenderness, bilateral
    FY2026 changes

Nearest Codes in This Family

Official ICD-10-CM classifications closest to R39.853 in its code family, with their registry titles.

View all codes in the R39 family