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v1.0.0
ICD-10 Guide
ICD-10 CodesR87.81

R87.81

High risk human papillomavirus (HPV) DNA test positive from female genital organs

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

Code Description

ICD-10 R87.81 is a billable code used to indicate a diagnosis of high risk human papillomavirus (hpv) dna test positive from female genital organs.

Key Diagnostic Point:

R87.81 is used to indicate a positive result from a high-risk human papillomavirus (HPV) DNA test conducted on samples obtained from female genital organs. HPV is a sexually transmitted infection that can lead to various health issues, including cervical cancer. The presence of high-risk HPV types, particularly HPV 16 and 18, is a significant risk factor for the development of cervical dysplasia and malignancy. Symptoms may not be present in many cases, as HPV infections can be asymptomatic. However, abnormal findings may include cervical dysplasia detected through Pap smears or visual examinations. The diagnosis is typically confirmed through molecular testing that identifies high-risk HPV DNA. Accurate coding is essential for appropriate patient management and treatment planning, as well as for tracking epidemiological trends in HPV-related diseases.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between high-risk and low-risk HPV types
  • Understanding the implications of positive test results
  • Navigating the relationship between HPV and cervical cancer screening
  • Documenting the absence of symptoms despite a positive test

Audit Risk Factors

  • Inadequate documentation of test results
  • Failure to link the diagnosis to clinical findings
  • Misclassification of HPV type
  • Inconsistent coding of related procedures

Specialty Focus

Medical Specialties

Internal Medicine

Documentation Requirements

Documentation should include the reason for testing, results of the HPV test, and any follow-up actions taken.

Common Clinical Scenarios

Routine screening for cervical cancer in women aged 30 and older, follow-up after abnormal Pap results.

Billing Considerations

Ensure that the patient's history includes any previous HPV infections or treatments.

Emergency Medicine

Documentation Requirements

Acute care documentation should detail the patient's presenting symptoms, test results, and any immediate interventions.

Common Clinical Scenarios

Patients presenting with abnormal vaginal bleeding or pelvic pain who undergo HPV testing.

Billing Considerations

Consider the urgency of the situation and document any immediate referrals to gynecology.

Coding Guidelines

Inclusion Criteria

Use R87.81 When
  • Follow the official ICD
  • CM guidelines for coding and reporting, ensuring that the code is used in conjunction with appropriate clinical documentation that supports the diagnosis

Exclusion Criteria

Do NOT use R87.81 When
No specific exclusions found.

Related CPT Codes

87624CPT Code

HPV DNA test

Clinical Scenario

Used when a patient has a positive Pap smear and requires HPV testing.

Documentation Requirements

Document the reason for the test, results, and any follow-up actions.

Specialty Considerations

Ensure that the test is performed in accordance with guidelines for cervical cancer screening.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of HPV-related conditions, improving the accuracy of data collection and patient management.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of HPV-related conditions, improving the accuracy of data collection and patient management.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of HPV-related conditions, improving the accuracy of data collection and patient management.

Resources

Clinical References

  • •
    CDC HPV Information

Coding & Billing References

  • •
    CDC HPV Information

Frequently Asked Questions

What does a positive high-risk HPV test mean?

A positive high-risk HPV test indicates the presence of HPV types that are associated with an increased risk of cervical cancer. It is important to follow up with appropriate screening and management.