ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 R10.10

Billable / Specific

Upper abdominal pain, unspecified

R10
Block
0
Synonyms
178
LCDs
11
Payer Policies
4
Linked CPTs

About ICD-10-CM R10.10

ICD-10-CM code R10.10 represents Upper abdominal pain, unspecified. This is a billable/specific code in the Symptoms, Signs, and Abnormal Findings chapter (block R10). The 2026 edition of ICD-10-CM R10.10 became effective on October 1, 2025.

Medicare LCD Coverage for R10.10

Local Coverage Determinations (LCDs) from CMS MACs that list R10.10 as a covered diagnosis.

178 LCDs

Showing top 10 of 178 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74170 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74177 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74160 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74178 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74150 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 72194 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74176 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 72192 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 72193 →
CMS LCD: Billing and Coding: Wireless Capsule Endoscopy
Article ID: 56727, Effective: 2025-10-01 00:00:00, 88 covered, 0 non-covered
CPT 91111 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing R10.10.

11 policies

5 Medicare

Billing and Coding: Nerve Blockade for Treatment of Chronic Pain and Neuropathy
Policy ID: ART-56034
Billing and Coding: CT of the Abdomen and Pelvis
Policy ID: ART-56421
Billing and Coding: Continuous Peripheral Nerve Blocks (CPNB)
Policy ID: ART-56607
Billing and Coding: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy
Policy ID: ART-56632
Billing and Coding: Wireless Capsule Endoscopy
Policy ID: ART-56727

CPT Codes Commonly Billed with R10.10

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

4 linkages
  • 43239 EGD with biopsy — abdominal pain, GERD, gastritis, ulcer Gastroenterology
  • 43235 Diagnostic EGD — abdominal pain, nausea, vomiting, GERD, gastric ulcer, gastritis, hematemesis, melena, Barrett esophagus, dysphagia, esophagitis, weight loss, iron deficiency anemia, polyp Gastroenterology
  • 74177 CT abdomen/pelvis with contrast — abdominal pain, colon cancer staging, liver mets, cholelithiasis, pancreatitis, chronic pancreatitis, pancreatic cancer, hepatomegaly, splenomegaly, abnormal imaging Radiology
  • 74176 CT abdomen/pelvis without contrast — same indications as with contrast when contrast contraindicated Radiology

Convert R10.10 to ICD-9-CM

Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.

ICD-10ICD-9Mapping Flags
R10.10 78909 10000

Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).

ICD-10 R10.10, Billing FAQ

Is ICD-10 code R10.10 billable? +

Yes, R10.10 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What CPT codes are commonly billed with R10.10? +

Procedures frequently paired with R10.10 include: 43239, 43235, 74177, 74176.

What ICD-9 codes does R10.10 map to? +

Per CMS GEMs, R10.10 maps to ICD-9 codes: 78909. Useful for legacy data review and historical claim analysis.

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Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on May 31, 2026.

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