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R86 ICD-10-CM Code: Abnormal findings in specimens from male genital organs

R86 is not a CMS-HCC payment code. MEAT criteria · RAF calculator · HCC coding software

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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 other body fluids, substances and tissues, without diagnosis (R83-R89)

R86

Header CodeICD-10-CMOfficial ICD-10-CMCodebook guidance

Abnormal findings in specimens from male genital organs

Abnormal findings in specimens from male genital organs

CMS-HCC V28

N/A

Not mapped

CMS-HCC V24

N/A

Not mapped

ACA/HHS

N/A

Not mapped

ESRD/PACE

N/A

Not mapped

RXHCC

N/A

Not mapped

Code Book Path

Official
R8Abnormal findings on examination of other body fluids, substances and tissues, without diagnosis (R83-R89)
R86Abnormal findings in specimens from male genital organs

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for R86 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for R86 in this effective period.

Related Child Codes

Official
R86.0Abnormal level of enzymes in specimens from male genital organs
R86.1Abnormal level of hormones in specimens from male genital organs
R86.2Abnormal level of other drugs, medicaments and biological substances in specimens from male genital organs
R86.3Abnormal level of substances chiefly nonmedicinal as to source in specimens from male genital organs
R86.4Abnormal immunological findings in specimens from male genital organs

Includes

Official
  • abnormal findings in prostatic secretions
  • abnormal findings in semen, seminal fluid
  • abnormal spermatozoa

Excludes 1

Official
  • azoospermia (N46.0-)
  • oligospermia (N46.1-)

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for R86 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for R86 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for R86 in this effective period.

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 →

Code
R86
Description
Abnormal findings in specimens from male genital organs
HCC (V28)
No CMS-HCC V28 mapping
RAF
Billable
No
Payment year
2026

Coder workflow notes

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What This Code Means

R86 is the ICD-10-CM diagnosis code for abnormal findings in specimens from male genital organs. R86 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 other body fluids, substances and tissues, without diagnosis (r83-r89).

Header codes like R86 cannot be reported on claims directly, they organize child codes that share clinical context but the actual diagnosis must be coded to the highest level of specificity supported by the documentation. Coders should look at R86's child codes and select the one that matches the patient's documented presentation, since payers reject header codes submitted as the primary diagnosis. For risk adjustment workflows, header codes never contribute to a Medicare Advantage member's RAF score on their own; only billable child codes that happen to map to a payment HCC affect risk-adjusted plan payments.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for R86 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Includes

  • abnormal findings in prostatic secretions
  • abnormal findings in semen, seminal fluid
  • abnormal spermatozoa

Excludes 1, Do NOT code together

Child Codes

Code Hierarchy

R86Abnormal findings in specimens from male genital organs
R86Abnormal findings in specimens from male genital organs

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