R75
BillableInconclusive laboratory evidence of human immunodeficiency virus [HIV]
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is R75 an HCC code?
No. R75 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
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 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 code indicates indeterminate or inconclusive results - follow-up testing is typically required.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for R75 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.