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R94.7

Billable

Abnormal results of other endocrine function studies

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

Is R94.7 an HCC code?

No. R94.7 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

R94.7 is the ICD-10-CM diagnosis code for abnormal results of other endocrine function studies. Test results showing abnormal function of endocrine glands other than the thyroid, such as abnormal pituitary, adrenal, or pancreatic hormone levels. R94.7 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).

R94.7 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.

Specify which endocrine gland's function is abnormal in documentation.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for R94.7 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • Specify which endocrine gland's function is abnormal in documentation
  • Link to specific endocrine disorder codes (E20-E35) when a diagnosis is established

Excludes 2 — Not included here, may code separately

  • abnormal glucose (R73.0-)

Code Hierarchy

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