R19.00 ICD-10-CM Code: Intra-abdominal and pelvic swelling, mass and lump, unspecified site
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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)
R19.00
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceIntra-abdominal and pelvic swelling, mass and lump, unspecified site
A swelling, mass, or lump felt in the abdomen or pelvis, but the specific location within the abdomen has not been identified.
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
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Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for R19.00 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for R19.00 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for R19.00 in this effective period.
Excludes 1
Official- abdominal distension (gaseous) (R14.-)
- ascites (R18.-)
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for R19.00 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for R19.00 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for R19.00 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 R19.00 an HCC code?
No. R19.00 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
R19.00 is the ICD-10-CM diagnosis code for intra-abdominal and pelvic swelling, mass and lump, unspecified site. A swelling, mass, or lump felt in the abdomen or pelvis, but the specific location within the abdomen has not been identified. R19.00 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).
R19.00 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.
Attempt to determine and document the specific quadrant or location to use a more specific code (R19.01-R19.04).
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for R19.00 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.