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ICD-10 Guide
ICD-10 CodesR85.4

R85.4

Abnormal immunological findings in specimens from digestive organs and abdominal cavity

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/11/2025

Code Description

ICD-10 R85.4 is a billable code used to indicate a diagnosis of abnormal immunological findings in specimens from digestive organs and abdominal cavity.

Key Diagnostic Point:

R85.4 is used to classify abnormal immunological findings in specimens obtained from the digestive organs and abdominal cavity. These findings may include abnormal levels of immunoglobulins, autoantibodies, or other immune markers that indicate an underlying pathological process. Such abnormalities can arise from various conditions, including autoimmune diseases, infections, malignancies, or inflammatory processes affecting the gastrointestinal tract. The clinical significance of these findings often necessitates further investigation to determine the underlying cause, which may involve additional laboratory tests, imaging studies, or biopsies. Accurate coding of R85.4 requires a thorough understanding of the patient's clinical context and the specific immunological tests performed, as well as the interpretation of results in relation to the patient's symptoms and medical history.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of underlying conditions that can cause abnormal findings
  • Need for correlation with clinical symptoms and history
  • Potential for overlapping symptoms with other diagnoses
  • Variability in laboratory testing methods and interpretations

Audit Risk Factors

  • Insufficient documentation linking abnormal findings to clinical conditions
  • Failure to specify the type of immunological test performed
  • Inconsistent coding of related symptoms or conditions
  • Lack of follow-up documentation for abnormal findings

Specialty Focus

Medical Specialties

Internal Medicine

Documentation Requirements

Detailed patient history, laboratory results, and correlation with clinical findings.

Common Clinical Scenarios

Patients presenting with unexplained gastrointestinal symptoms and abnormal immunological test results.

Billing Considerations

Ensure that the documentation clearly states the relationship between the abnormal findings and the patient's symptoms.

Emergency Medicine

Documentation Requirements

Acute care documentation including immediate lab results and clinical assessments.

Common Clinical Scenarios

Patients with acute abdominal pain and abnormal immunological findings requiring urgent evaluation.

Billing Considerations

Document the urgency of the findings and any immediate interventions taken.

Coding Guidelines

Inclusion Criteria

Use R85.4 When
  • Follow the official ICD
  • CM guidelines for coding and reporting, ensuring that the code is used only when there is clear documentation of abnormal immunological findings related to digestive organs or the abdominal cavity

Exclusion Criteria

Do NOT use R85.4 When
No specific exclusions found.

Related CPT Codes

86328CPT Code

Immunoassay for antibodies

Clinical Scenario

Used when testing for specific immunological markers related to digestive disorders.

Documentation Requirements

Document the specific antibodies tested and the clinical rationale for testing.

Specialty Considerations

Ensure that the specialty performing the test is noted, as it may affect coding.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of abnormal immunological findings, improving the granularity of data for research and clinical care. R85.4 provides a distinct code for findings related specifically to the digestive system, enhancing the accuracy of patient records.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of abnormal immunological findings, improving the granularity of data for research and clinical care. R85.4 provides a distinct code for findings related specifically to the digestive system, enhancing the accuracy of patient records.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of abnormal immunological findings, improving the granularity of data for research and clinical care. R85.4 provides a distinct code for findings related specifically to the digestive system, enhancing the accuracy of patient records.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What types of tests are associated with R85.4?

R85.4 is associated with various immunological tests, including those for autoantibodies, immunoglobulin levels, and specific antigen tests related to digestive organ conditions.