R10.813 — Right lower quadrant abdominal tenderness
R10.813 is a billable, specific ICD-10-CM code for right lower quadrant abdominal tenderness. It is valid for submission on a claim.
Risk adjustment
R10.813 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
R10.813 is named in 9 Medicare coverage policies — 9 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A55937Billing and Coding: Diagnostic Colonoscopy
- A56421Billing and Coding: CT of the Abdomen and Pelvis
- A57063Billing and Coding: Diagnostic and Therapeutic Esophagogastroduodenoscopy
- A58428Billing and Coding: Diagnostic Colonoscopy
How R10.813 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 R10.813.
- Tenderness, abdominal›right lower quadrant
Related codes at this level
Codes that share R10.81. If R10.813 is not quite right, the correct code is usually one of these.
- R10.811Right upper quadrant abdominal tenderness
- R10.812Left upper quadrant abdominal tenderness
- R10.814Left lower quadrant abdominal tenderness
- R10.815Periumbilic abdominal tenderness
- R10.816Epigastric abdominal tenderness
- R10.817Generalized abdominal tenderness
- R10.819Abdominal tenderness, unspecified site
Questions about R10.813
- Is R10.813 a billable ICD-10-CM code?
- Yes. R10.813 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does R10.813 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).