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R76.11

Billable

Nonspecific reaction to tuberculin skin test without active tuberculosis

Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)

Is R76.11 an HCC code?

No. R76.11 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

R76.11 is the ICD-10-CM diagnosis code for nonspecific reaction to tuberculin skin test without active tuberculosis. A tuberculin skin test (TB test) shows a reaction, but the person does not have active tuberculosis disease. R76.11 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).

R76.11 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 indicates either latent TB infection or a false positive reaction - clinical correlation is essential.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for R76.11 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • This indicates either latent TB infection or a false positive reaction - clinical correlation is essential
  • Document whether the patient has symptoms of TB or known TB exposure to guide further workup

Excludes 1 — Do NOT code together

  • nonspecific reaction to cell mediated immunity measurement of gamma interferon antigen response without active tuberculosis (R76.12)

Code Hierarchy

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