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R87.621 ICD-10-CM Code: Atypical squamous cells cannot exclude high grade squamous intraepithelial lesion on cytologic smear of vagina (ASC-H)

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

Coding at a Glance

Tabular directives
3 inclusion terms · 10 Excludes1 · 5 Excludes2 · 1 use-additional code

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 742 — UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITH CC/MCC (MDC 13)
  • MS-DRG 743 — UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC (MDC 13)
  • MS-DRG 760 — MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITH CC/MCC (MDC 13)
  • MS-DRG 761 — MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITHOUT CC/MCC (MDC 13)

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 R87.621 in the official ICD-10-CM tabular list, quoted as published.

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

Notes without a marker are published on R87.621 itself; “inherited from” names the category or block whose note applies here.

Includes

Conditions the official ICD-10-CM tabular list includes under this code.

  • abnormal findings in secretion and smears from cervix uteri
  • abnormal findings in secretion and smears from vagina
  • abnormal findings in secretion and smears from vulva

Source: inherited from R87

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.

Use Additional Code

Supplementary codes the tabular list directs you to add.

  • Use additional code to identify acquired absence of uterus and cervix, if applicable (Z90.71-)

Source: inherited from R87.62

Coder workflow for R87.621

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

Before you code R87.621

  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 R87.621. 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 R87.621’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.

    ReviewR87.61, R87.69, D07.2, N89, O28

Consider R87.621. Then work the Use Additional Code note, and 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 conditions the Use Additional Code note names
Reported with this code when documented; a conditional instruction (“if applicable”, “if known”) applies only when the record supports it.

Official instructions as workflow

  • Excludes1 — check before selecting R87.621(10 notes)

    Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with R87.621: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.

    CompareR87.61, R87.69, D07.2, N89, O28

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

  • Excludes2 — not part of R87.621(5 notes)

    Coding workflow: The conditions named in this note are not included in R87.621. When the record documents both, both may be reported; the note is a boundary, not a prohibition.

    CompareR87.811, R87.821, R97

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

  • Use Additional Code — after identifying R87.621(1 note)

    Coding workflow: Check whether the documentation supports the additional code(s) the note names, and report them with R87.621 when it does. Where the instruction is conditional (“if applicable”, “if known”), it applies only when the record documents the condition.

    ReviewZ90.71

    See the official tabular notes · Guidelines I.A.13

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 R87.621 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 R87.621 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).

ReviewR87.61, R87.69, D07.2, N89, O28

Documentation: A condition the Use Additional Code note names is documented.

Coding question: Is a second code reported with R87.621?

Path: Review the Use Additional Code note and the code it names.

Reason: The additional code is reported when the record documents the condition; a conditional instruction applies only when its condition is met (Guidelines I.A.13).

ReviewZ90.71

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

Atypical squamous cells cannot exclude high grade squamous intraepithelial lesion on cytologic smear of vagina (ASC-H) is a billable ICD-10-CM diagnosis code (R87.621).

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 (2)

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.

Decision Points

The directives on this code's own record, as a pre-claim checklist.

  1. 1 Use Additional Code instruction — report the named additional code(s) when the documentation supports them. See the Use Additional Code notes
  2. 10 Excludes1 entries — codes named there are generally not reported together with this code (Guidelines I.A.12.a). See the Excludes1 notes
  3. 5 Excludes2 entries — those conditions are not part of this code and may be reported additionally when documented. See the Excludes2 notes

Checklist rows are derived from this code's own official directives; the wording of each check is MedCoder editorial. The official notes themselves are in the sections each row links to.

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 R87.621 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 2 Excludes1 notes across 2 chapters: N89 — Other noninflammatory disorders of vagina (via R87.62.-), R87.61 — Abnormal cytological findings in specimens from cervix uteri (via R87.62.-).

These codes’ tabular lists mark this diagnosis as mutually exclusive — not reported together unless the conditions are documented as unrelated.

MS-DRG Grouper Relationships (FY2026)

Potential MS-DRG participation — not a DRG assignment.

FY2026 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 4 MS-DRGs: DRG 742 (MDC 13), DRG 743 (MDC 13), DRG 760 (MDC 13), DRG 761 (MDC 13).

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).

R87.610 — Atypical squamous cells of undetermined significance on cytologic smear of cervix (ASC-US), R87.611 — Atypical squamous cells cannot exclude high grade squamous intraepithelial lesion on cytologic smear of cervix (ASC-H), R87.612 — Low grade squamous intraepithelial lesion on cytologic smear of cervix (LGSIL), R87.613 — High grade squamous intraepithelial lesion on cytologic smear of cervix (HGSIL), R87.614 — Cytologic evidence of malignancy on smear of cervix, R87.615 — Unsatisfactory cytologic smear of cervix, R87.616 — Satisfactory cervical smear but lacking transformation zone, R87.618 — Other abnormal cytological findings on specimens from cervix uteri, R87.619 — Unspecified abnormal cytological findings in specimens from cervix uteri, R87.620 — Atypical squamous cells of undetermined significance on cytologic smear of vagina (ASC-US), R87.622 — Low grade squamous intraepithelial lesion on cytologic smear of vagina (LGSIL), R87.623 — High grade squamous intraepithelial lesion on cytologic smear of vagina (HGSIL), R87.624 — Cytologic evidence of malignancy on smear of vagina, R87.625 — Unsatisfactory cytologic smear of vagina, R87.628 — Other abnormal cytological findings on specimens from vagina, R87.629 — Unspecified abnormal cytological findings in specimens from vagina, R87.69 — Abnormal cytological findings in specimens from other female genital organs, R87.7 — Abnormal histological findings in specimens from female genital organs, R87.810 — Cervical high risk human papillomavirus (HPV) DNA test positive, R87.811 — Vaginal high risk human papillomavirus (HPV) DNA test positive, +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.

R86.0 — Abnormal level of enzymes in specimens from male genital organs (specimen, male genital organs, enzyme level), R86.1 — Abnormal level of hormones in specimens from male genital organs (specimen, male genital organs, hormones), R86.2 — Abnormal level of other drugs, medicaments and biological substances in specimens from male genital organs (specimen, male genital organs, drug level), R86.3 — Abnormal level of substances chiefly nonmedicinal as to source in specimens from male genital organs (specimen, male genital organs, nonmedicinal level), R86.4 — Abnormal immunological findings in specimens from male genital organs (specimen, male genital organs, immunology), R86.5 — Abnormal microbiological findings in specimens from male genital organs (specimen, male genital organs, microbiology), R86.6 — Abnormal cytological findings in specimens from male genital organs (Papanicolaou, seminal fluid), R86.7 — Abnormal histological findings in specimens from male genital organs (specimen, male genital organs, histological), R86.8 — Other abnormal findings in specimens from male genital organs (specimen, male genital organs, specified type NEC), R86.9 — Unspecified abnormal finding in specimens from male genital organs (specimen, male genital organs), R89.0 — Abnormal level of enzymes in specimens from other organs, systems and tissues (specimen, specified organ, system and tissue NOS, enzyme level), R89.1 — Abnormal level of hormones in specimens from other organs, systems and tissues (specimen, specified organ, system and tissue NOS, hormones), R89.2 — Abnormal level of other drugs, medicaments and biological substances in specimens from other organs, systems and tissues (specimen, specified organ, system and tissue NOS, drug level), R89.3 — Abnormal level of substances chiefly nonmedicinal as to source in specimens from other organs, systems and tissues (specimen, specified organ, system and tissue NOS, nonmedicinal level), R89.4 — Abnormal immunological findings in specimens from other organs, systems and tissues (immunological findings), R89.5 — Abnormal microbiological findings in specimens from other organs, systems and tissues (specimen, specified organ, system and tissue NOS, microbiology), R89.6 — Abnormal cytological findings in specimens from other organs, systems and tissues (Papanicolaou, sites NEC), R89.7 — Abnormal histological findings in specimens from other organs, systems and tissues (myoglobin), R89.8 — Other abnormal findings in specimens from other organs, systems and tissues (karyotype), R89.9 — Unspecified abnormal finding in specimens from other organs, systems and tissues (specimen, specified organ, system and tissue NOS), +210 more

Contextual Map

Every relationship of R87.621 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 R87.621 with these 2 related codes in Claim Check

Hierarchy

Referenced by Excludes1 notes

Clinical classification (CCSR)

MS-DRG Grouper

MDC crossing

  • MDC 13 — Diseases and Disorders of the Female Reproductive System[MDC crossing]: “Diseases and Disorders of the Female Reproductive System — 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. 2,232 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2026

Index entries

  • Abnormal, abnormality, abnormalities, Papanicolaou (smear), vagina, atypical squamous cells cannot exclude high grade squamous intraepithelial lesion (ASC-H)[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • ASC-H (atypical squamous cells cannot exclude high grade squamous intraepithelial lesion on cytologic smear), vagina[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026

Nearest codes (37)

Change history

  • FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016

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

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. "R87.621 — Atypical squamous cells cannot exclude high grade squamous intraepithelial lesion on cytologic smear of vagina (ASC-H)." ICD-10-CM FY2026. https://medcoder.ai/icd10/code/r87.621-atypical-squamous-cells-cannot-exclude-high-grade-squamous-intraepithelial-lesion-on-cytologic-smear-of-vagina-asc-h

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Atypical squamous cells cannot exclude high grade squamous intraepithelial lesion on cytologic smear of vagina (ASC-H)

No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027 (effective October 1, 2026), and none are recorded for this code. Note changes are tracked from FY2027 only.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to R87.621 in its code family, with their registry titles.

View all codes in the R87 family