R10.812 ICD-10-CM Code: Left upper quadrant abdominal tenderness
HCC Buddy Code Card
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FY 2026 Apr update / Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99) / Symptoms and signs involving the digestive system and abdomen (R10-R19)
R10.812
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceLeft upper quadrant abdominal tenderness
Tenderness to touch or palpation in the left upper portion of the abdomen.
CMS-HCC V28
00
RAF 0
CMS-HCC V24
00
RAF 0
ACA/HHS
00
RAF 0
ESRD/PACE
00
RAF 0
RXHCC
00
RAF 0
Code Trumping
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Code Book Path
Inclusion Terms
Official- Abdominal tenderness NOS
Excludes 2
Official- pain localized to other parts of lower abdomen (R10.3-)
- pain localized to upper abdomen (R10.1-)
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for R10.812 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for R10.812 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for R10.812 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for R10.812 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for R10.812 in this effective period.
Buddy Documentation Tip
Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.
Is R10.812 an HCC code?
No. R10.812 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
Coder workflow notes
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This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
R10.812 is the ICD-10-CM diagnosis code for left upper quadrant abdominal tenderness. Tenderness to touch or palpation in the left upper portion of the abdomen. R10.812 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).
R10.812 is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.
Distinguish between tenderness (examination finding) and pain (patient symptom); use R10.812 for palpation findings only.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for R10.812 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Distinguish between tenderness (examination finding) and pain (patient symptom); use R10.812 for palpation findings only
- •Document severity and whether tenderness is localized or diffuse across the left upper quadrant