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

ICD-10 R10.2

Non-Billable Header

Pelvic and perineal pain

R10
Block
0
Synonyms
0
LCDs
1
Payer Policies
5
Linked CPTs

About ICD-10-CM R10.2

ICD-10-CM code R10.2 represents Pelvic and perineal pain. This is a non-billable header code in the Symptoms, Signs, and Abnormal Findings chapter (block R10). The 2026 edition of ICD-10-CM R10.2 became effective on October 1, 2025. Non-billable codes cannot be used as a primary or secondary diagnosis on a claim, use a more specific child code instead.

Type 1 Excludes

Pure excludes, these codes can never be coded together with R10.2. The conditions are mutually exclusive (e.g., congenital vs acquired forms).

  • vulvodynia (N94.81)

Type 2 Excludes

Not included here, the excluded code is not part of R10.2, but a patient may have both conditions at the same time. Both codes may be coded together when applicable.

  • pain localized to other parts of lower abdomen (R10.3-)
  • pain localized to upper abdomen (R10.1-)

Medicare LCD Coverage for R10.2

Local Coverage Determinations (LCDs) from CMS MACs that list R10.2 as a covered diagnosis.

No Medicare LCDs reference R10.2 as covered

This doesn't mean the code isn't covered, it means no MAC has issued a Local Coverage Determination naming this specific code. Coverage may still apply under National Coverage Determinations or general medical-necessity rules.

Commercial Payer Coverage

Coverage policies from major commercial payers referencing R10.2.

1 policies

1 Aetna

Cholecystokinin Cholescintigraphy
Policy ID: CPB-0266

CPT Codes Commonly Billed with R10.2

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

5 linkages
  • 10021 Fine needle aspiration biopsy Emergency Medicine
  • 10022 Fine needle aspiration biopsy, with ultrasound guidance Emergency Medicine
  • 10060 Incision and drainage of abscess Emergency Medicine
  • 10120 Incision and drainage of hematoma Emergency Medicine
  • 76857 Pelvic ultrasound non-OB — BPH, urinary retention, hematuria, poor stream, hydronephrosis, bladder cancer, pelvic pain, cystitis Urology

Convert R10.2 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
R10.2 6089 10000
R10.2 6259 10000
R10.2 78909 10000

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

ICD-10 R10.2, Billing FAQ

Is ICD-10 code R10.2 billable? +

No, R10.2 is a non-billable header code. Use a more specific child code from block R10 when submitting claims.

What codes are Type 1 Excludes for R10.2? +

Type 1 Excludes (never code together with R10.2): vulvodynia (N94.81)

What codes are Type 2 Excludes for R10.2? +

Type 2 Excludes (may be coded together when both conditions exist): pain localized to other parts of lower abdomen (R10.3-); pain localized to upper abdomen (R10.1-)

What CPT codes are commonly billed with R10.2? +

Procedures frequently paired with R10.2 include: 10021, 10022, 10060, 10120, 76857.

What ICD-9 codes does R10.2 map to? +

Per CMS GEMs, R10.2 maps to ICD-9 codes: 6089, 6259, 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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