R10.11 — Right upper quadrant pain
R10.11 is a billable, specific ICD-10-CM code for right upper quadrant pain. It is valid for submission on a claim.
Risk adjustment
R10.11 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.
Medicare coverage
R10.11 is named in 27 Medicare coverage policies — 27 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A55336Billing and Coding: Retroperitoneal Ultrasound
- A56034Billing and Coding: Nerve Blockade for Treatment of Chronic Pain and Neuropathy
- A56389Billing and Coding: Upper Gastrointestinal Endoscopy and Visualization
- A56421Billing and Coding: CT of the Abdomen and Pelvis
How R10.11 is indexed
Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to R10.11.
- Pain›abdominal›upper›right quadrant
Related codes at this level
Codes that share R10.1. If R10.11 is not quite right, the correct code is usually one of these.
Questions about R10.11
- Is R10.11 a billable ICD-10-CM code?
- Yes. R10.11 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does R10.11 sit in the tabular list?
- Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99), in the block Symptoms and signs involving the digestive system and abdomen (R10-R19).