R92.343 ICD-10-CM Code: Mammographic extreme density, bilateral breasts
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FY 2026 Apr update / Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99) / Abnormal findings on diagnostic imaging and in function studies, without diagnosis (R90-R94)
R92.343
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceMammographic extreme density, bilateral breasts
A mammogram showing very dense breast tissue in both breasts, which may reduce the sensitivity of mammographic screening.
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
Inclusion Terms
Official- Breast density category within Imaging Reporting and Data System (BI-RADS): D
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for R92.343 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for R92.343 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for R92.343 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for R92.343 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for R92.343 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for R92.343 in this effective period.
Buddy Documentation Tip
Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.
Is R92.343 an HCC code?
No. R92.343 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
Coder workflow notes
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This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
R92.343 is the ICD-10-CM diagnosis code for mammographic extreme density, bilateral breasts. A mammogram showing very dense breast tissue in both breasts, which may reduce the sensitivity of mammographic screening. R92.343 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 diagnostic imaging and in function studies, without diagnosis (r90-r94).
R92.343 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.
Bilateral extreme density may prompt recommendations for additional imaging modalities.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for R92.343 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Bilateral extreme density may prompt recommendations for additional imaging modalities
- •Document any clinical recommendations for supplemental screening in the medical record