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

ICD-10 R31.9

Billable / Specific

Hematuria, unspecified

R31
Block
0
Synonyms
39
LCDs
7
Payer Policies
5
Linked CPTs

About ICD-10-CM R31.9

ICD-10-CM code R31.9 represents Hematuria, unspecified. This is a billable/specific code in the Symptoms, Signs, and Abnormal Findings chapter (block R31). The 2026 edition of ICD-10-CM R31.9 became effective on October 1, 2025.

Medicare LCD Coverage for R31.9

Local Coverage Determinations (LCDs) from CMS MACs that list R31.9 as a covered diagnosis.

39 LCDs

Showing top 10 of 39 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: Genetic Testing in Oncology: Specific Tests
Article ID: 59125, Effective: 2025-04-24 00:00:00, 19 covered, 0 non-covered
CPT 0229U →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing R31.9.

7 policies

1 Cigna

Transvaginal Ultrasound, Non-Obstetrical - (0398)
Policy ID: MM_0398

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: Duplex Scanning
Policy ID: ART-57636
Billing and Coding: Lab: Cystatin C Measurement
Policy ID: ART-57643
Billing and Coding: Genetic Testing in Oncology: Specific Tests
Policy ID: ART-59123

CPT Codes Commonly Billed with R31.9

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

5 linkages
  • 52000 Cystoscopy — hematuria, cystitis, bladder outlet obstruction, BPH Urology
  • 52000 Cystoscopy diagnostic — bladder neck obstruction, cystitis, hematuria, hydronephrosis, bladder cancer, BPH, urinary retention, urethral stricture, poor stream, bladder calculus Urology
  • 52601 TURP — BPH with LUTS, BPH, urinary retention, poor stream, hydronephrosis, bladder neck obstruction, hematuria Urology
  • 76857 Pelvic ultrasound non-OB — BPH, urinary retention, hematuria, poor stream, hydronephrosis, bladder cancer, pelvic pain, cystitis Urology
  • 82610 CMS LCD: Billing and Coding: Lab: Cystatin C Measurement CMS LCD

Convert R31.9 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
R31.9 59970 00000

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

ICD-10 R31.9, Billing FAQ

Is ICD-10 code R31.9 billable? +

Yes, R31.9 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 R31.9? +

Procedures frequently paired with R31.9 include: 52000, 52000, 52601, 76857, 82610.

What ICD-9 codes does R31.9 map to? +

Per CMS GEMs, R31.9 maps to ICD-9 codes: 59970. 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 June 1, 2026.

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