R94.8
BillableAbnormal results of function studies of other organs and systems
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is R94.8 an HCC code?
No. R94.8 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
R94.8 is the ICD-10-CM diagnosis code for abnormal results of function studies of other organs and systems. Test results showing abnormal function of organs or body systems not covered by other R94 codes, such as lung, gastrointestinal, or immune function studies. R94.8 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).
R94.8 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.
This is a catch-all code; be as specific as possible in documentation about which organ system is affected.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for R94.8 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This is a catch-all code; be as specific as possible in documentation about which organ system is affected
- •Review other R94 codes first to ensure a more specific code doesn't apply