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

ICD-10 R10.9

Billable / Specific

Unspecified abdominal pain

R10
Block
0
Synonyms
185
LCDs
17
Payer Policies
12
Linked CPTs

About ICD-10-CM R10.9

ICD-10-CM code R10.9 represents Unspecified abdominal pain. This is a billable/specific code in the Symptoms, Signs, and Abnormal Findings chapter (block R10). The 2026 edition of ICD-10-CM R10.9 became effective on October 1, 2025.

Medicare LCD Coverage for R10.9

Local Coverage Determinations (LCDs) from CMS MACs that list R10.9 as a covered diagnosis.

185 LCDs

Showing top 10 of 185 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 R10.9.

17 policies

5 Aetna

Allergy and Hypersensitivity - Medical Clinical Policy Bulletins | Aetna
Policy ID: CPB-0038
Transvaginal Ultrasonography
Policy ID: CPB-0530
Lead Testing
Policy ID: CPB-0553
Celiac Disease Laboratory Testing
Policy ID: CPB-0561
Capsule Endoscopy
Policy ID: CPB-0588

5 Medicare

Billing and Coding: Retroperitoneal Ultrasound
Policy ID: ART-55336
Billing and Coding: CT of the Abdomen and Pelvis
Policy ID: ART-56421
Billing and Coding: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy
Policy ID: ART-56456
Billing and Coding: Computerized Axial Tomography (CT), Thorax
Policy ID: ART-56580
Billing and Coding: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy
Policy ID: ART-56632

CPT Codes Commonly Billed with R10.9

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

12 linkages
  • 43239 EGD with biopsy — abdominal pain, GERD, gastritis, ulcer Gastroenterology
  • 99202 New patient office visit — fever, headache, abdominal pain, cough, dyspnea, fatigue, dizziness, limb pain, nausea, routine exam, URI, UTI, pharyngitis, otitis, chest pain, weight loss Primary Care
  • 99203 New patient office visit — common complaints plus chronic conditions: HTN, diabetes, hyperlipidemia, asthma, GERD, back pain, migraine, tachycardia, prediabetes Primary Care
  • 99212 Established patient — URI, UTI, pharyngitis, otitis, dermatitis, rash, viral infection, cellulitis, conjunctivitis, sinusitis, bronchitis, ankle sprain Primary Care
  • 99213 Established patient — HTN follow-up, diabetes management, hyperlipidemia, asthma, anxiety, common complaints, back pain, GERD, migraine, acne, joint pain, prediabetes, obesity, anemia, hypothyroid, fatigue Primary Care
  • 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
  • 50590 Lithotripsy — kidney stone, ureter stone, kidney/ureter stone, obstructive uropathy, abdominal pain, abnormal urine Urology
  • 99281 ED visit level 1 — fever, cough, URI, abdominal pain, dizziness, laceration, ankle sprain, nausea, minor injury Emergency Medicine

Convert R10.9 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
R10.9 78900 10000

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

ICD-10 R10.9, Billing FAQ

Is ICD-10 code R10.9 billable? +

Yes, R10.9 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 R10.9? +

Procedures frequently paired with R10.9 include: 43239, 99202, 99203, 99212, 99213.

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

Per CMS GEMs, R10.9 maps to ICD-9 codes: 78900. 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 July 17, 2026.

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