ICD-10 Guide

R93.5

Abnormal findings on diagnostic imaging of other abdominal regions, including retroperitoneum

BILLABLE STATUSYes

IMPLEMENTATION DATEOctober 1, 2015

LAST UPDATED09/11/2025

Code Description

ICD-10 R93.5 is a billable code used to indicate a diagnosis of abnormal findings on diagnostic imaging of other abdominal regions, including retroperitoneum.

Key Diagnostic Point:

The ICD-10 code R93.5 is used to classify abnormal findings observed on diagnostic imaging studies of the abdominal regions not specifically categorized elsewhere, including the retroperitoneum. This code encompasses a variety of imaging modalities such as ultrasound, CT scans, and MRI, which may reveal anomalies such as masses, fluid collections, or structural abnormalities. Common findings may include lymphadenopathy, hematomas, or organomegaly, which can indicate underlying pathologies such as malignancies, infections, or inflammatory processes. The clinical significance of these findings often necessitates further evaluation or intervention, making accurate coding essential for appropriate patient management and billing. Coders must ensure that the imaging findings are well-documented in the medical record, including the specific location and nature of the abnormality, to support the use of this code.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

Variety of potential findings that can be coded under this category
Need for precise documentation of imaging results
Differentiation from other abdominal imaging codes
Potential overlap with other ICD-10 codes for specific conditions

Audit Risk Factors

Inadequate documentation of imaging findings
Failure to specify the location of the abnormality
Misuse of the code when a more specific diagnosis exists
Lack of correlation between imaging findings and clinical symptoms

Specialty Focus

Medical Specialties

Internal Medicine

Documentation Requirements

Documentation must include detailed descriptions of imaging findings, clinical correlation, and any follow-up actions taken.

Common Clinical Scenarios

Patients presenting with abdominal pain or unexplained weight loss who undergo imaging studies revealing abnormalities.

Billing Considerations

Consideration of the patient's history and presenting symptoms is crucial for accurate coding.

Emergency Medicine

Documentation Requirements

Acute care documentation should include the reason for imaging, findings, and any immediate interventions performed.

Common Clinical Scenarios

Patients with acute abdominal pain requiring urgent imaging to rule out conditions like appendicitis or perforation.

Billing Considerations

Rapid assessment and documentation are essential in emergency settings to ensure accurate coding.

Coding Guidelines

Inclusion Criteria

Use R93.5 When

According to the official coding guidelines, R93
5 should be used when the abnormal findings are not classified elsewhere and when the findings are significant enough to warrant further clinical action or monitoring

Exclusion Criteria

Do NOT use R93.5 When

No specific exclusions found.

Related CPT Codes

74176CPT Code

CT abdomen and pelvis with contrast

Clinical Scenario

Used when imaging is performed to investigate abdominal symptoms.

Documentation Requirements

Document the reason for the CT scan and findings.

Specialty Considerations

Ensure that the imaging report is available for 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 findings, improving the granularity of data collection and enhancing the ability to track and manage patient outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of abnormal findings, improving the granularity of data collection and enhancing the ability to track and manage patient outcomes.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of abnormal findings, improving the granularity of data collection and enhancing the ability to track and manage patient 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

When should I use R93.5?

Use R93.5 when there are abnormal findings on imaging studies of the abdominal regions that do not fit into more specific categories and require further clinical evaluation.

ICD-10 R93.5 is a billable code used to indicate a diagnosis of abnormal findings on diagnostic imaging of other abdominal regions, including retroperitoneum.