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ICD-10 Guide
ICD-10 CodesR86.1

R86.1

Abnormal level of hormones in specimens from male genital organs

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

Code Description

ICD-10 R86.1 is a billable code used to indicate a diagnosis of abnormal level of hormones in specimens from male genital organs.

Key Diagnostic Point:

R86.1 refers to abnormal hormone levels detected in specimens obtained from male genital organs, such as blood, urine, or tissue samples. Hormones such as testosterone, luteinizing hormone (LH), and follicle-stimulating hormone (FSH) play critical roles in male reproductive health. Abnormal levels can indicate various conditions, including hypogonadism, tumors, or endocrine disorders. Symptoms may include changes in libido, erectile dysfunction, infertility, or gynecomastia. Laboratory findings may reveal elevated or decreased hormone levels compared to normal ranges, necessitating further investigation to determine underlying causes. Clinicians must consider the patient's clinical history, physical examination findings, and additional diagnostic tests to establish a comprehensive understanding of the patient's hormonal status and its implications for health.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of potential underlying conditions leading to abnormal hormone levels.
  • Need for comprehensive laboratory testing and interpretation.
  • Differentiation between primary and secondary causes of hormonal imbalance.
  • Potential overlap with other endocrine disorders requiring careful documentation.

Audit Risk Factors

  • Inadequate documentation of laboratory results.
  • Failure to specify the type of hormone tested.
  • Lack of correlation between symptoms and abnormal findings.
  • Misclassification of the underlying condition causing hormonal imbalance.

Specialty Focus

Medical Specialties

Internal Medicine

Documentation Requirements

Detailed documentation of patient history, physical examination findings, and laboratory results is essential.

Common Clinical Scenarios

Evaluation of patients presenting with symptoms of hypogonadism or infertility.

Billing Considerations

Consideration of comorbid conditions that may affect hormone levels, such as obesity or diabetes.

Emergency Medicine

Documentation Requirements

Acute care documentation must include immediate lab results and clinical findings.

Common Clinical Scenarios

Patients presenting with acute symptoms related to hormonal imbalances, such as severe erectile dysfunction or acute testicular pain.

Billing Considerations

Rapid assessment and documentation of any acute complications related to hormonal abnormalities.

Coding Guidelines

Inclusion Criteria

Use R86.1 When
  • Follow official ICD
  • CM guidelines for coding symptoms and abnormal findings, ensuring that the code is used in conjunction with appropriate clinical documentation and laboratory results

Exclusion Criteria

Do NOT use R86.1 When
No specific exclusions found.

Related CPT Codes

84100CPT Code

Testosterone, total

Clinical Scenario

Used when testing for testosterone levels in patients suspected of having hormonal imbalances.

Documentation Requirements

Document the reason for testing and the specific hormone levels obtained.

Specialty Considerations

Endocrinologists may require additional tests to assess the full hormonal profile.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of hormonal abnormalities, improving the granularity of data for research and treatment outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of hormonal abnormalities, improving the granularity of data for research and treatment outcomes.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of hormonal abnormalities, improving the granularity of data for research and treatment outcomes.

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 symptoms warrant the use of R86.1?

Symptoms such as decreased libido, erectile dysfunction, infertility, or gynecomastia may warrant the use of R86.1 when associated with abnormal hormone levels.