R75 ICD-10-CM Code: Inconclusive laboratory evidence of human immunodeficiency virus [HIV]
R75 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · free HCC coding tools
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FY 2026 Apr update / Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99) / Abnormal findings on examination of blood, without diagnosis (R70-R79)
R75
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceInconclusive laboratory evidence of human immunodeficiency virus [HIV]
HIV test results are unclear or inconclusive, meaning the test cannot definitively confirm or rule out HIV infection at this time.
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
HistoricalHistorical
Not used for CY2026 payment
ACA/HHS
N/A—
Not mapped
ESRD/PACE
N/A—
Not mapped
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
Official- Nonconclusive HIV-test finding in infants
Excludes 2
Official- abnormal findings on antenatal screening of mother (O28.-)Inherited from R00-R99, R70-R79
- certain conditions originating in the perinatal period (P04-P96)Inherited from R00-R99, R70-R79
- signs and symptoms classified in the body system chaptersInherited from R00-R99, R70-R79
- signs and symptoms of breast (N63, N64.5)Inherited from R00-R99, R70-R79
- abnormalities of lipids (E78.-)Inherited from R00-R99, R70-R79
- abnormalities of platelets and thrombocytes (D69.-)Inherited from R00-R99, R70-R79
- abnormalities of white blood cells classified elsewhere (D70-D72)Inherited from R00-R99, R70-R79
- coagulation hemorrhagic disorders (D65-D68)Inherited from R00-R99, R70-R79
- diagnostic abnormal findings classified elsewhere - see Alphabetical IndexInherited from R00-R99, R70-R79
- hemorrhagic and hematological disorders of newborn (P50-P61)Inherited from R00-R99, R70-R79
Related Codes
No related codes are included in this display for R75. Check the Code Book for the complete code path.
Includes
OfficialNo Includes notes are included in this display for R75. Check the code and parent instructions in the Code Book.
Excludes 1
Official- asymptomatic human immunodeficiency virus [HIV] infection status (Z21)
- human immunodeficiency virus [HIV] disease (B20)
Code First
OfficialNo Code First sequencing instructions are included in this display for R75. Check the code and parent instructions in the Code Book.
Use Additional
OfficialNo Use Additional Code instructions are included in this display for R75. Check the code and parent instructions in the Code Book.
Code Also
OfficialNo Code Also instructions are included in this display for R75. Check the code and parent instructions in the Code Book.
Buddy Documentation Tip
Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →
Is R75 an HCC code?
No. R75 is a billable ICD-10-CM code with no mapping under the current CMS-HCC V28 community payment model, and none under the ESRD, Part D RxHCC, or HHS-HCC models.
- Code
- R75
- Description
- Inconclusive laboratory evidence of human immunodeficiency virus [HIV]
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF reference coefficient
- —
- Billable
- Yes
- Payment year
- 2026
Coder workflow notes
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What This Code Means
R75 is the ICD-10-CM diagnosis code for inconclusive laboratory evidence of human immunodeficiency virus [hiv]. HIV test results are unclear or inconclusive, meaning the test cannot definitively confirm or rule out HIV infection at this time. R75 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 abnormal findings on examination of blood, without diagnosis (r70-r79).
R75 is a billable ICD-10-CM code, but no current CMS-HCC V28 community payment mapping is shown, and none under the ESRD, Part D RxHCC, or HHS-HCC models. Do not assign risk adjustment value from this page when no source-backed mapping is shown; verify the applicable model and payment year.
This code indicates indeterminate or inconclusive results - follow-up testing is typically required.
HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for R75 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.