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

ICD-10 R76.81

Billable / Specific

Abnormal rheumatoid factor and anti-citrullinated protein antibody without rheumatoid arthritis

R76
Block
2
Synonyms
14
LCDs
2
Payer Policies
0
Linked CPTs

About ICD-10-CM R76.81

ICD-10-CM code R76.81 represents Abnormal rheumatoid factor and anti-citrullinated protein antibody without rheumatoid arthritis. This is a billable/specific code in the Symptoms, Signs, and Abnormal Findings chapter (block R76). The 2026 edition of ICD-10-CM R76.81 became effective on October 1, 2025.

Inclusion Terms / Approximate Synonyms

Clinical terms and conditions classified under R76.81. Per CMS ICD-10-CM Tabular 2026.

  • Abnormal anti-CCP
  • Abnormal anti-cyclic citrullinated protein antibody and rheumatoid factor

Type 1 Excludes

Pure excludes, these codes can never be coded together with R76.81. The conditions are mutually exclusive (e.g., congenital vs acquired forms).

  • rheumatoid arthritis with rheumatoid factor (M05.-)

Medicare LCD Coverage for R76.81

Local Coverage Determinations (LCDs) from CMS MACs that list R76.81 as a covered diagnosis.

14 LCDs

Showing top 10 of 14 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: Lab: Bladder/Urothelial Tumor Markers
Article ID: 55028, Effective: 2025-11-06 00:00:00, 60 covered, 0 non-covered
CPT 88120 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing R76.81.

2 policies

2 Medicare

Billing and Coding: Lab: Bladder/Urothelial Tumor Markers
Policy ID: ART-55028
Billing and Coding: CT of the Abdomen and Pelvis
Policy ID: ART-56421

CPT Codes Commonly Billed with R76.81

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

No procedure linkages on file for R76.81

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.

ICD-10 R76.81, Billing FAQ

Is ICD-10 code R76.81 billable? +

Yes, R76.81 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 R76.81? +

ICD-10 R76.81 includes: Abnormal anti-CCP; Abnormal anti-cyclic citrullinated protein antibody and rheumatoid factor.

What codes are Type 1 Excludes for R76.81? +

Type 1 Excludes (never code together with R76.81): rheumatoid arthritis with rheumatoid factor (M05.-)

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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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