R94.5 — Abnormal results of liver function studies
R94.5 is a billable, specific ICD-10-CM code for abnormal results of liver function studies. It is valid for submission on a claim.
Risk adjustment
R94.5 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
R94.5 is named in 6 Medicare coverage policies — 6 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A56421Billing and Coding: CT of the Abdomen and Pelvis
- A57591Billing and Coding: Non-Invasive Abdominal / Visceral Vascular Studies
- A60205Billing and Coding: MolDX: Biomarker Testing in Metabolic Dysfunction-Associated Steatotic Liver Disease and Metabolic Dysfunction-Associated Steatohepatitis
- A60215Billing and Coding: MolDX: Biomarker Testing in Metabolic Dysfunction-Associated Steatotic Liver Disease and Metabolic Dysfunction-Associated Steatohepatitis
How R94.5 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 R94.5.
- Abnormal, abnormality, abnormalities›function studies›liver
- Elevated, elevation›liver function›study
- Findings, abnormal, inconclusive, without diagnosis›function study NEC›liver
Related codes at this level
Codes that share R94. If R94.5 is not quite right, the correct code is usually one of these.
- R94.0Abnormal results of function studies of central nervous system
- R94.1Abnormal results of function studies of peripheral nervous system and special senses
- R94.2Abnormal results of pulmonary function studies
- R94.3Abnormal results of cardiovascular function studies
- R94.4Abnormal results of kidney function studies
- R94.6Abnormal results of thyroid function studies
- R94.7Abnormal results of other endocrine function studies
- R94.8Abnormal results of function studies of other organs and systems
Questions about R94.5
- Is R94.5 a billable ICD-10-CM code?
- Yes. R94.5 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does R94.5 sit in the tabular list?
- Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99), in the block Abnormal findings on diagnostic imaging and in function studies, without diagnosis (R90-R94).