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ICD-10 Guide
ICD-10 CodesR87.811

R87.811

Vaginal high risk human papillomavirus (HPV) DNA test positive

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

Code Description

ICD-10 R87.811 is a billable code used to indicate a diagnosis of vaginal high risk human papillomavirus (hpv) dna test positive.

Key Diagnostic Point:

The ICD-10 code R87.811 is used to indicate a positive result from a vaginal high-risk human papillomavirus (HPV) DNA test. This finding is significant as high-risk HPV types are associated with the development of cervical cancer and other anogenital malignancies. The presence of high-risk HPV DNA in the vaginal sample suggests that the patient may be at increased risk for cervical dysplasia or cancer, necessitating further evaluation and management. Symptoms may not be present, as many individuals with HPV are asymptomatic. However, abnormal cervical cytology results, such as atypical squamous cells or squamous intraepithelial lesions, may accompany a positive HPV test. The clinical context often involves routine screening in women aged 30 and older, where HPV testing is performed alongside Pap smears to assess cervical health. Follow-up procedures may include colposcopy and biopsy to evaluate any cervical lesions. Accurate coding for this condition is crucial for appropriate patient management and tracking of HPV-related health outcomes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Need for precise documentation of test results and clinical context.
  • Differentiation between high-risk and low-risk HPV types.
  • Understanding of associated follow-up procedures and their coding.
  • Potential for co-existing conditions affecting coding.

Audit Risk Factors

  • Inadequate documentation of HPV test results.
  • Failure to document follow-up procedures or management plans.
  • Misclassification of HPV type (high-risk vs. low-risk).
  • Lack of correlation between symptoms and test results.

Specialty Focus

Medical Specialties

Internal Medicine

Documentation Requirements

Documentation must include the reason for HPV testing, results, and any follow-up plans.

Common Clinical Scenarios

Routine screening in women over 30, management of abnormal Pap results.

Billing Considerations

Consideration of patient history, including previous HPV infections and cervical treatments.

Emergency Medicine

Documentation Requirements

Acute care documentation should include the patient's presenting symptoms and any immediate interventions.

Common Clinical Scenarios

Patients presenting with abnormal vaginal bleeding or pelvic pain.

Billing Considerations

Emergency settings may require rapid assessment and referral for follow-up care.

Coding Guidelines

Inclusion Criteria

Use R87.811 When
  • Follow official ICD
  • 10 coding guidelines, ensuring that the code is used only when a high
  • risk HPV DNA test is confirmed positive
  • Document the clinical rationale for testing and any subsequent findings or treatments

Exclusion Criteria

Do NOT use R87.811 When
No specific exclusions found.

Related CPT Codes

87624CPT Code

HPV DNA test, high-risk types

Clinical Scenario

Used when a patient is tested for high-risk HPV types during routine screening.

Documentation Requirements

Document the reason for testing and the results.

Specialty Considerations

Ensure that the test is linked to appropriate follow-up care.

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 strategies.

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 strategies.

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 strategies.

Resources

Clinical References

  • •
    CDC HPV Information

Coding & Billing References

  • •
    CDC HPV Information

Frequently Asked Questions

What does a positive HPV DNA test mean?

A positive HPV DNA test indicates the presence of high-risk HPV types that may lead to cervical cancer. It is essential to follow up with appropriate screenings and potential treatments.