ICD-10 Guide

R87

Non-billable

Abnormal findings in specimens from female genital organs

Chapter 18:Symptoms, signs and abnormal clinical findings

BILLABLE STATUSNo

IMPLEMENTATION DATEOctober 1, 2015

LAST UPDATED09/05/2025

Code Description

ICD-10 R87 is a used to indicate a diagnosis of abnormal findings in specimens from female genital organs.

Key Diagnostic Point:

The ICD-10 Level 1 Category code R87 encompasses abnormal findings in specimens obtained from female genital organs. This category is crucial for identifying and coding various pathological conditions that may arise from cytological or histological examinations of specimens such as Pap smears, biopsies, and other diagnostic tests. Conditions covered under this category may include atypical squamous cells, dysplasia, and other abnormalities that warrant further investigation or intervention. Proper coding in this category is essential for accurate diagnosis, treatment planning, and monitoring of female reproductive health issues.

Clinically, the findings coded under R87 can indicate a range of conditions from benign lesions to precancerous changes and malignancies. The significance of these findings often necessitates follow-up procedures, additional testing, or referrals to specialists. Usage guidelines for R87 codes emphasize the importance of precise documentation to ensure that the findings are accurately represented and that the appropriate level of care is provided. This category plays a vital role in women's health management and preventive care strategies.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

Variety of conditions covered
Need for precise documentation
Potential for follow-up procedures

Audit Risk Factors

Inadequate documentation
Misinterpretation of findings
Failure to follow up on abnormal results

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Pathology

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Related CPT Codes

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Population health implications are also noteworthy, as the data collected through the use of R87 codes can inform public health strategies aimed at reducing the incidence of cervical and other reproductive cancers. By tracking abnormal findings, healthcare providers can identify at-risk populations and implement targeted screening and education programs, ultimately contributing to better health outcomes for women.

ICD-9 vs ICD-10

The clinical impact of the R87 code category is significant, as it directly relates to women's health and the early detection of potential malignancies. Accurate coding can lead to timely interventions, improved patient outcomes, and enhanced quality of care. Administratively, the proper use of R87 codes can influence healthcare trends by highlighting the prevalence of abnormal findings and guiding resource allocation for preventive care initiatives. Population health implications are also noteworthy, as the data collected through the use of R87 codes can inform public health strategies aimed at reducing the incidence of cervical and other reproductive cancers. By tracking abnormal findings, healthcare providers can identify at-risk populations and implement targeted screening and education programs, ultimately contributing to better health outcomes for women.

Reimbursement & Billing Impact

Reimbursement considerations include the complexity of the findings and the necessity for follow-up care. Providers should ensure that all documentation supports the coding used, as this will affect reimbursement rates and claims processing. It is also important to be aware of payer-specific guidelines that may influence billing practices.

Resources

Clinical References

•
Official ICD-10 Guidelines for R87

Coding & Billing References

•
Official ICD-10 Guidelines for R87

Frequently Asked Questions

What conditions are included in R87?

R87 includes abnormal findings such as atypical squamous cells, dysplasia, and other cytological or histological abnormalities detected in specimens from female genital organs.

When should I use R87 codes?

R87 codes should be used when reporting abnormal findings from diagnostic tests involving female genital specimens, particularly when further investigation or treatment is indicated.

What documentation is required for R87?

Documentation must include the type of specimen collected, the findings from the examination, and any recommendations for follow-up or additional testing.

ICD-10 R87 is a used to indicate a diagnosis of abnormal findings in specimens from female genital organs.

Key Diagnostic Point:

Clinically, the findings coded under R87 can indicate a range of conditions from benign lesions to precancerous changes and malignancies. The significance of these findings often necessitates follow-up procedures, additional testing, or referrals to specialists. Usage guidelines for R87 codes emphasize the importance of precise documentation to ensure that the findings are accurately represented and that the appropriate level of care is provided. This category plays a vital role in women's health management and preventive care strategies.