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R10.85

Billable

Abdominal pain of multiple sites

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

Is R10.85 an HCC code?

No. R10.85 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.

This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).

What This Code Means

R10.85 is the ICD-10-CM diagnosis code for abdominal pain of multiple sites. Abdominal pain occurring in two or more different locations within the abdomen simultaneously or at different times. R10.85 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).

R10.85 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.

Document each specific site of pain to justify the use of this code over single-site codes.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for R10.85 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • Document each specific site of pain to justify the use of this code over single-site codes
  • Consider whether the multiple sites represent a single underlying condition or separate issues

Excludes 1 — Do NOT code together

  • abdominal rigidity NOS (R19.3)
  • generalized abdominal pain associated with acute abdomen (R10.0)
  • generalized abdominal pain NOS (R10.84)
  • localized abdominal pain (R10.1-R10.4-)

Code Hierarchy

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