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

ICD-10 R75

Billable / Specific

Inconclusive laboratory evidence of human immunodeficiency virus [HIV]

R75
Block
1
Synonyms
0
LCDs
1
Payer Policies
0
Linked CPTs

About ICD-10-CM R75

ICD-10-CM code R75 represents Inconclusive laboratory evidence of human immunodeficiency virus [HIV]. This is a billable/specific code in the Symptoms, Signs, and Abnormal Findings chapter (block R75). The 2026 edition of ICD-10-CM R75 became effective on October 1, 2025.

Inclusion Terms / Approximate Synonyms

Clinical terms and conditions classified under R75. Per CMS ICD-10-CM Tabular 2026.

  • Nonconclusive HIV-test finding in infants

Type 1 Excludes

Pure excludes, these codes can never be coded together with R75. The conditions are mutually exclusive (e.g., congenital vs acquired forms).

  • asymptomatic human immunodeficiency virus [HIV] infection status (Z21)
  • human immunodeficiency virus [HIV] disease (B20)

Medicare LCD Coverage for R75

Local Coverage Determinations (LCDs) from CMS MACs that list R75 as a covered diagnosis.

No Medicare LCDs reference R75 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 R75.

1 policies

1 Cigna

Flow Cytometry - (0538)
Policy ID: MM_0538

CPT Codes Commonly Billed with R75

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

No procedure linkages on file for R75

We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.

Convert R75 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
R75 79571 10000

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

ICD-10 R75, Billing FAQ

Is ICD-10 code R75 billable? +

Yes, R75 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What other names or terms map to R75? +

ICD-10 R75 includes: Nonconclusive HIV-test finding in infants.

What codes are Type 1 Excludes for R75? +

Type 1 Excludes (never code together with R75): asymptomatic human immunodeficiency virus [HIV] infection status (Z21); human immunodeficiency virus [HIV] disease (B20)

What ICD-9 codes does R75 map to? +

Per CMS GEMs, R75 maps to ICD-9 codes: 79571. 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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