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R76.81 ICD-10-CM Code: Abnormal rheumatoid factor and anti-citrullinated protein antibody without rheumatoid arthritis

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

Coding at a Glance

Tabular directives
2 inclusion terms · 1 Excludes1 · 7 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 v43, Appendix B.

  • MS-DRG 814 — RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH MCC (MDC 16)
  • MS-DRG 815 — RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH CC (MDC 16)
  • MS-DRG 816 — RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITHOUT CC/MCC (MDC 16)

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 R76.81 in the official ICD-10-CM tabular list, quoted as published.

Notes without a marker are published on R76.81 itself; “inherited from” names the category or block whose note applies here.

Inclusion Terms

Alternative terms the tabular list files under this code.

  • Abnormal anti-CCP
  • Abnormal anti-cyclic citrullinated protein antibody and rheumatoid factor

Excludes1 — Not Coded Here

Conditions generally not reported together with this code (Excludes1) -- an error unless the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Excludes2 — Not Included Here

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

Source: inherited from R70-R79

Coder workflow for R76.81

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

Before you code R76.81

  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. Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with R76.81. Excludes1 conditions are not reported together with this code unless the record shows they are unrelated (Guidelines I.A.12.a).

    See the official tabular notes

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. Does the documentation support a condition named in R76.81’s Excludes1 note?
    Yes → Do not simply proceed: review the excluded code. Both are reported only when the record shows the two conditions are unrelated.
    No → Continue.

    ReviewM05

Consider R76.81. 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).
The associated condition or complication
Whether the associated condition the title names is documented; the “with” convention presumes some links, and a provider statement that the conditions are unrelated defeats it (Guidelines I.A.15).

Official instructions as workflow

  • Excludes1 — check before selecting R76.81(1 note)

    Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with R76.81: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.

    CompareM05

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

  • Excludes2 — not part of R76.81(7 notes)

    Coding workflow: The conditions named in this note are not included in R76.81. When the record documents both, both may be reported; the note is a boundary, not a prohibition.

    CompareO28, E78, D69

    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 R76.81 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: Both the condition R76.81 describes and a condition named in its Excludes1 note are documented for the same encounter.

Coding question: Can both codes be reported?

Path: Review the Excludes1 note and the excluded code, and look for a provider statement on whether the two conditions are related.

Reason: Excludes1 means the two are not coded together; the exception is when the record shows the conditions are unrelated to each other (Guidelines I.A.12.a).

ReviewM05

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

Abnormal rheumatoid factor and anti-citrullinated protein antibody without rheumatoid arthritis is a billable ICD-10-CM diagnosis code (R76.81).

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 (3)

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 R76.81 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 8 Excludes2 notes: R83 — Abnormal findings in cerebrospinal fluid (via R76.-), R83-R89 — Abnormal findings on examination of other body fluids, substances and tissues, without diagnosis (R83-R89) (via R76.-), R84 — Abnormal findings in specimens from respiratory organs and thorax (via R76.-), R85 — Abnormal findings in specimens from digestive organs and abdominal cavity (via R76.-), R86 — Abnormal findings in specimens from male genital organs (via R76.-), R87 — Abnormal findings in specimens from female genital organs (via R76.-), R88 — Abnormal findings in other body fluids and substances (via R76.-), R89 — Abnormal findings in specimens from other organs, systems and tissues (via R76.-).

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

MS-DRG Grouper Relationships (FY2026)

Potential MS-DRG participation — not a DRG assignment.

Not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity.

Named in the grouper logic of 3 MS-DRGs: DRG 814 (MDC 16), DRG 815 (MDC 16), DRG 816 (MDC 16).

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

Clinical classification (AHRQ CCSR):SYM017 — Abnormal findings without diagnosis (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 (Abnormal findings without diagnosis).

R74.0 — Nonspecific elevation of levels of transaminase and lactic acid dehydrogenase [LDH], R74.01 — Elevation of levels of liver transaminase levels, R74.02 — Elevation of levels of lactic acid dehydrogenase [LDH], R74.8 — Abnormal levels of other serum enzymes, R74.9 — Abnormal serum enzyme level, unspecified, R75 — Inconclusive laboratory evidence of human immunodeficiency virus [HIV], R76.0 — Raised antibody titer, R76.11 — Nonspecific reaction to tuberculin skin test without active tuberculosis, R76.12 — Nonspecific reaction to cell mediated immunity measurement of gamma interferon antigen response without active tuberculosis, R76.8 — Other specified abnormal immunological findings in serum, R76.89 — Other specified abnormal immunological findings in serum, R76.9 — Abnormal immunological finding in serum, unspecified, R77.0 — Abnormality of albumin, R77.1 — Abnormality of globulin, R77.2 — Abnormality of alphafetoprotein, R77.8 — Other specified abnormalities of plasma proteins, R77.9 — Abnormality of plasma protein, unspecified, R78.71 — Abnormal lead level in blood, R78.79 — Finding of abnormal level of heavy metals in blood, R78.81 — Bacteremia, +183 more

Same Index main term, other category

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

R29.890 — Loss of height (loss of, height), R39.198 — Other difficulties with micturition (urination NEC), R63.2 — Polyphagia (increase in appetite), R63.4 — Abnormal weight loss (loss of, weight), R68.89 — Other general symptoms and signs (clinical findings NEC), R70.1 — Abnormal plasma viscosity (plasma, viscosity), R71.8 — Other abnormality of red blood cells (red blood cell), R73.09 — Other abnormal glucose (blood sugar), R74.8 — Abnormal levels of other serum enzymes (serum level, lipase), R74.9 — Abnormal serum enzyme level, unspecified (serum level, enzymes), R77.0 — Abnormality of albumin (albumin), R77.1 — Abnormality of globulin (globulin), R77.2 — Abnormality of alphafetoprotein (alphafetoprotein), R77.8 — Other specified abnormalities of plasma proteins (plasma, protein, specified NEC), R77.9 — Abnormality of plasma protein, unspecified (plasma, protein), R78.89 — Finding of other specified substances, not normally found in blood (blood level, lithium), R78.9 — Finding of unspecified substance, not normally found in blood (toxicology), R79.0 — Abnormal level of blood mineral (blood level, iron), R79.1 — Abnormal coagulation profile (bleeding time), R79.81 — Abnormal blood-gas level (blood-gas level), +237 more

Contextual Map

Every relationship of R76.81 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 R76.81 with these 9 related codes in Claim Check

Hierarchy

Excludes1

Referenced by Excludes2 notes

Clinical classification (CCSR)

MS-DRG Grouper

MDC crossing

  • MDC 16 — Diseases and Disorders of Blood, Blood Forming Organs and Immunologic Disorders[MDC crossing]: “Diseases and Disorders of Blood, Blood Forming Organs and Immunologic Disorders — 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. 1,614 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2026

Index entries

  • Abnormal, abnormality, abnormalities, anti-CCP (cyclic citrullinated protein)[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Abnormal, abnormality, abnormalities, anti-cyclic citrullinated protein antibody and rheumatoid factor[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Abnormal, abnormality, abnormalities, rheumatoid factor and anti-citrullinated protein antibody, without rheumatoid arthritis[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026

Nearest codes

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 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
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 — v43 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

Change history

  • FY2026 — October 1, 2025
    Added to the code set
    Abnormal rheumatoid factor and anti-citrullinated protein antibody without rheumatoid arthritis
    FY2026 changes

Nearest Codes in This Family

Official ICD-10-CM classifications closest to R76.81 in its code family, with their registry titles.

View all codes in the R76 family