R31.21
BillableAsymptomatic microscopic hematuria
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is R31.21 an HCC code?
No. R31.21 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
R31.21 is the ICD-10-CM diagnosis code for asymptomatic microscopic hematuria. Microscopic blood in the urine detected only under a microscope in a patient with no urinary symptoms. R31.21 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 genitourinary system (r30-r39).
R31.21 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.
This is an incidental finding; ensure the patient has no dysuria, frequency, urgency, or other urinary symptoms.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for R31.21 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This is an incidental finding; ensure the patient has no dysuria, frequency, urgency, or other urinary symptoms
- •May require follow-up testing to rule out underlying pathology despite asymptomatic presentation