Question 1

What is ICD-10 code R10.8A3?

Accepted Answer

R10.8A3 is the ICD-10-CM diagnosis code for suprapubic tenderness. Tenderness or pain felt in the area just above the pubic bone in the lower central abdomen. R10.8A3 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).

R10.8A3 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.

Suprapubic tenderness may suggest bladder, prostate, or gynecological pathology depending on patient gender.

Question 2

Is R10.8A3 an HCC code?

Accepted Answer

No. R10.8A3 is a billable ICD-10-CM code but does not map to any payment HCC category under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can still be reported on Medicare Advantage encounter data submissions, but it does not contribute to the beneficiary's Risk Adjustment Factor (RAF) score and therefore does not affect the risk-adjusted capitation payment to the plan. V28 reached 100% phase-in for payment year 2026.

Question 3

Is R10.8A3 billable?

Accepted Answer

Yes. R10.8A3 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. R10.8A3 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

Question 4

Which HCC does R10.8A3 map to under V28?

Accepted Answer

R10.8A3 does not map to a CMS-HCC V28 payment category. Check the current CMS-HCC V28 model file for payment year 2026 rather than an older V24 tip sheet.

Question 5

What does R10.8A3 pay in RAF?

Accepted Answer

R10.8A3 has no separately stated V28 community RAF weight. If it is not a V28 payment HCC, it adds nothing to a community RAF score.

Question 6

What is the V28 vs V24 difference for R10.8A3?

Accepted Answer

R10.8A3 does not map to a payment HCC under either the CMS-HCC V28 risk adjustment model or the older V24 model. V28 reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition. Because neither community model rewards R10.8A3 with a risk adjustment factor, it contributes zero to a Medicare Advantage beneficiary's V28/V24 community RAF score in either version. Coders should check whether provider documentation supports a more specific child code that does map to a community payment HCC.

Question 7

What documentation supports R10.8A3?

Accepted Answer

Suprapubic tenderness may suggest bladder, prostate, or gynecological pathology depending on patient gender Correlate with urinalysis and imaging findings to identify underlying causes R10.8A3 is not a CMS-HCC payment code, so MEAT is not the payment hook. Documentation still has to support the diagnosis if you report it.

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R10.8A3

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R10.8A3 ICD-10-CM Code: Suprapubic tenderness

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R10.8A3

Is R10.8A3 an HCC code?

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R10.8A3 code history

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