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

ICD-10 R10.3

Non-Billable Header

Pain localized to other parts of lower abdomen

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

About ICD-10-CM R10.3

ICD-10-CM code R10.3 represents Pain localized to other parts of lower abdomen. This is a non-billable header code in the Symptoms, Signs, and Abnormal Findings chapter (block R10). The 2026 edition of ICD-10-CM R10.3 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 2 Excludes

Not included here, the excluded code is not part of R10.3, but a patient may have both conditions at the same time. Both codes may be coded together when applicable.

  • pain localized to flank (R10.A-)
  • pelvic and perineal pain (R10.2-)

Medicare LCD Coverage for R10.3

Local Coverage Determinations (LCDs) from CMS MACs that list R10.3 as a covered diagnosis.

No Medicare LCDs reference R10.3 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 R10.3.

No commercial payer policies reference R10.3 on file

Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but R10.3 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.

CPT Codes Commonly Billed with R10.3

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

4 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

ICD-10 R10.3, Billing FAQ

Is ICD-10 code R10.3 billable? +

No, R10.3 is a non-billable header code. Use a more specific child code from block R10 when submitting claims.

What codes are Type 2 Excludes for R10.3? +

Type 2 Excludes (may be coded together when both conditions exist): pain localized to flank (R10.A-); pelvic and perineal pain (R10.2-)

What CPT codes are commonly billed with R10.3? +

Procedures frequently paired with R10.3 include: 10021, 10022, 10060, 10120.

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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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