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R97.2 ICD-10-CM Code: Elevated prostate specific antigen [PSA]

Compare with another code for R97.2Check this code on a claim

Billing Status: NO. This is a non-billable ICD-10-CM code: report a more specific billable code beneath it.

Not billable · FY2027A non-billable heading in the tabular list: report a more specific code beneath it.

What you need to know

Source: CMS/NCHS Official ICD-10-CM tabular notes, quoted. From the CMS/NCHS tabular list for the release in force. A note the category or block publishes applies to this code too, and is marked with where it comes from.

The tabular list publishes no instructional note for this code itself.

Where it sits Source: CMS/NCHS

Under:Chapter 18: Symptoms, Signs and Abnormal Clinical and Laboratory Findings, Not Elsewhere ClassifiedR97 Abnormal tumor markers

Codes under R97.2 (2)

  • R97.20Elevated prostate specific antigen [PSA]Billable
  • R97.21Rising PSA following treatment for malignant neoplasm of prostateBillable

CompareCheck ClaimView Related Codes

Coder workflow for R97.2

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

Before you code R97.2

  1. R97.2 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).

    ReviewR97.20, R97.21

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

Choose the right path

  1. Does the documentation support one of the more specific codes beneath R97.2?
    Yes → Select that code and continue the checks below on its own page.
    No → R97.2 cannot be reported as written. Where the codes beneath it include an unspecified code, that code applies when the record goes no further; otherwise query for the missing detail.

    ReviewR97.20, R97.21

Report the code beneath R97.2 that the documentation supports, not R97.2 itself. Then confirm that code is valid for the date of service on its own page.

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).

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.

Coding context

Guidelines, coding notes, decision aids, relationships (with MS-DRG and CCSR classification), hierarchy, HCC, coverage and the context map: what a coder reaches for after the core. Each section names whether it is official source data, a MedCoder-derived relationship or MedCoder editorial.

Code Overview

Elevated prostate specific antigen [PSA] is a non-billable ICD-10-CM category code (R97.2). A more specific billable subcode must be selected for claims submission.

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

Verify Before Coding

  • Not billable as written — a more specific code is required: R97.20, R97.21.

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-derived relationships — computed from published CMS and AHRQ datasets

Other codes that name R97.2 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 R97.-), R83-R89 — Abnormal findings on examination of other body fluids, substances and tissues, without diagnosis (R83-R89) (via R97.-), R84 — Abnormal findings in specimens from respiratory organs and thorax (via R97.-), R85 — Abnormal findings in specimens from digestive organs and abdominal cavity (via R97.-), R86 — Abnormal findings in specimens from male genital organs (via R97.-), R87 — Abnormal findings in specimens from female genital organs (via R97.-), R88 — Abnormal findings in other body fluids and substances (via R97.-), R89 — Abnormal findings in specimens from other organs, systems and tissues (via R97.-).

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

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).

R94.120 — Abnormal auditory function study, R94.121 — Abnormal vestibular function study, R94.128 — Abnormal results of other function studies of ear and other special senses, R94.130 — Abnormal response to nerve stimulation, unspecified, R94.131 — Abnormal electromyogram [EMG], R94.138 — Abnormal results of other function studies of peripheral nervous system, R94.2 — Abnormal results of pulmonary function studies, R94.30 — Abnormal result of cardiovascular function study, unspecified, R94.31 — Abnormal electrocardiogram [ECG] [EKG], R94.39 — Abnormal result of other cardiovascular function study, R94.4 — Abnormal results of kidney function studies, R94.5 — Abnormal results of liver function studies, R94.6 — Abnormal results of thyroid function studies, R94.7 — Abnormal results of other endocrine function studies, R94.8 — Abnormal results of function studies of other organs and systems, R97.0 — Elevated carcinoembryonic antigen [CEA], R97.1 — Elevated cancer antigen 125 [CA 125], R97.20 — Elevated prostate specific antigen [PSA], R97.21 — Rising PSA following treatment for malignant neoplasm of prostate, R97.8 — Other abnormal tumor markers, +183 more

Contextual Map

Every relationship of R97.2 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 R97.2 with these 8 related codes in Claim Check

Hierarchy

Referenced by Excludes2 notes

Clinical classification (CCSR)

Nearest codes

Change history (2)

Reference

Index terms and tables, published questions and FAQ, every source behind this page with its release and checksum, the date-of-service check and the complete change history.

Common coding questions

MedCoder editorial

Can R97.2 be billed directly?

No. R97.2 (Elevated prostate specific antigen [PSA]) is a non-billable ICD-10-CM category code. A more specific billable subcode must be selected based on clinical documentation.

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
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-derived 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 editorial 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.

Current data releases:ICD-10-CM FY2027 · ICD-10-PCS FY2027 · HCPCS October 2026 · MS-DRG v44 · Medicare Code Editor v44.0 · NCCI PTP Q4 2026 · MUE Q4 2026 · NCD code lists 2026-01 · LCD export September 28, 2026 · All releases and sources

Labels on this page: Official source data · MedCoder-derived relationship · MedCoder editorial explanation. How to read the labels · All data sources and release dates · CMS coding rules

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. "R97.2 — Elevated prostate specific antigen [PSA]." ICD-10-CM FY2027. https://medcoder.ai/icd10/code/r97.2-elevated-prostate-specific-antigen-psa

Change history

  • FY2017 — October 1, 2016
    Became a non-billable header
    FY2017 changes
  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Elevated prostate specific antigen [PSA]

Nearest Codes in This Family

Official ICD-10-CM classifications closest to R97.2 in its code family, with their registry titles.

View all codes in the R97 family