ICD-10 R85.61
Non-Billable HeaderAbnormal cytologic smear of anus
About ICD-10-CM R85.61
ICD-10-CM code R85.61 represents Abnormal cytologic smear of anus. This is a non-billable header code in the Symptoms, Signs, and Abnormal Findings chapter (block R85). The 2026 edition of ICD-10-CM R85.61 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 1 Excludes
Pure excludes, these codes can never be coded together with R85.61. The conditions are mutually exclusive (e.g., congenital vs acquired forms).
- abnormal cytological findings in specimens from other digestive organs and abdominal cavity (R85.69)
- carcinoma in situ of anus (histologically confirmed) (D01.3)
- anal intraepithelial neoplasia I [AIN I] (K62.82)
- anal intraepithelial neoplasia II [AIN II] (K62.82)
- anal intraepithelial neoplasia III [AIN III] (D01.3)
- dysplasia (mild) (moderate) of anus (histologically confirmed) (K62.82)
- severe dysplasia of anus (histologically confirmed) (D01.3)
Type 2 Excludes
Not included here, the excluded code is not part of R85.61, but a patient may have both conditions at the same time. Both codes may be coded together when applicable.
- anal high risk human papillomavirus (HPV) DNA test positive (R85.81)
- anal low risk human papillomavirus (HPV) DNA test positive (R85.82)
Medicare LCD Coverage for R85.61
Local Coverage Determinations (LCDs) from CMS MACs that list R85.61 as a covered diagnosis.
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 R85.61.
Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but R85.61 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.
CPT Codes Commonly Billed with R85.61
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
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.
Codes Adjacent To R85.61
Other codes in section R83-R89 (Abnormal findings on examination of other body fluids, substances and tissues, without diagnosis).
ICD-10 R85.61, Billing FAQ
Is ICD-10 code R85.61 billable? +
No, R85.61 is a non-billable header code. Use a more specific child code from block R85 when submitting claims.
What codes are Type 1 Excludes for R85.61? +
Type 1 Excludes (never code together with R85.61): abnormal cytological findings in specimens from other digestive organs and abdominal cavity (R85.69); carcinoma in situ of anus (histologically confirmed) (D01.3); anal intraepithelial neoplasia I [AIN I] (K62.82)
What codes are Type 2 Excludes for R85.61? +
Type 2 Excludes (may be coded together when both conditions exist): anal high risk human papillomavirus (HPV) DNA test positive (R85.81); anal low risk human papillomavirus (HPV) DNA test positive (R85.82)
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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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