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R10

Non-Billable (Header)

Abdominal and pelvic pain

Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)

What This Code Means

R10 is the ICD-10-CM diagnosis code for abdominal and pelvic pain. R10 sits in the ICD-10-CM chapter for symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (r00-r99), within the section covering symptoms and signs involving the digestive system and abdomen (r10-r19).

Header codes like R10 cannot be reported on claims directly — they organize child codes that share clinical context but the actual diagnosis must be coded to the highest level of specificity supported by the documentation. Coders should look at R10's child codes and select the one that matches the patient's documented presentation, since payers reject header codes submitted as the primary diagnosis. For risk adjustment workflows, header codes never contribute to a Medicare Advantage member's RAF score on their own; only billable child codes that happen to map to a payment HCC affect risk-adjusted plan payments.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for R10 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Excludes 1 — Do NOT code together

  • renal colic (N23)

Excludes 2 — Not included here, may code separately

  • costovertebral (angle) tenderness (R39.85)
  • dorsalgia (M54.-)
  • flatulence and related conditions (R14.-)

Child Codes

Code Hierarchy

R10Abdominal and pelvic pain
R10Abdominal and pelvic pain

More on R10

Referenced in blog posts

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