R92.8 ICD-10-CM Code: Other abnormal and inconclusive findings on diagnostic imaging of breast
HCC Buddy Code Card
Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.
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)
R92.8
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceOther abnormal and inconclusive findings on diagnostic imaging of breast
A mammogram or other breast imaging study shows abnormal findings that don't fit into other specific categories or are unclear and need further evaluation.
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
OfficialICD-10-CM does not list inclusion terms for R92.8 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for R92.8 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for R92.8 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for R92.8 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for R92.8 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for R92.8 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for R92.8 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 R92.8 an HCC code?
No. R92.8 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
R92.8 is the ICD-10-CM diagnosis code for other abnormal and inconclusive findings on diagnostic imaging of breast. A mammogram or other breast imaging study shows abnormal findings that don't fit into other specific categories or are unclear and need further evaluation. R92.8 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).
R92.8 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.
Use this code when findings are inconclusive or don't match other R92 codes.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for R92.8 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Use this code when findings are inconclusive or don't match other R92 codes
- •Document the specific abnormality noted and any recommendations for follow-up imaging