2024 ICD-10-CM Diagnosis Code R85.7

Abnormal histological findings in specimens from digestive organs and abdominal cavity

ICD-10-CM Code:: R85.7
ICD-10 Code for:: Abnormal histolog findings in specmn from dgstv org/abd cav
Is Billable?: Yes - Valid for Submission
Chronic Condition Indicator: ^[1]: Not chronic
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Table of Contents

Code Information
Approximate Synonyms
Clinical Classification
Tabular List of Diseases and Injuries
Index to Diseases and Injuries References
Diagnostic Related Groups Mapping
Convert to ICD-9 Code
Patient Education
Other Codes Used Similar Conditions
Code History

Code Classification

Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified
(R00–R99)
- Abnormal findings on examination of other body fluids, substances and tissues, without diagnosis
  (R83-R89)
  - Abnormal findings in specimens from digestive organs and abdominal cavity
    (R85)

R85.7 is a billable diagnosis code used to specify a medical diagnosis of abnormal histological findings in specimens from digestive organs and abdominal cavity. The code is valid during the current fiscal year for the submission of HIPAA-covered transactions from October 01, 2023 through September 30, 2024.

According to ICD-10-CM guidelines this code should not to be used as a principal diagnosis code when a related definitive diagnosis has been established.

Approximate Synonyms

The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:

Ampulla of Vater surgical margin, involved by tumor
Ampulla of Vater surgical margin, involved by tumor
Ampulla of Vater surgical margin, involved by tumor
Ampulla of Vater, distal pancreatic surgical margin, involved by tumor
Ampulla of Vater, posterior retroperitoneal pancreatic surface surgical margin, involved by tumor
Anal, deep radial surgical margin involved by tumor
Anal, distal surgical margin involved by tumor
Anal, proximal surgical margin involved by tumor
Artifact
Common bile duct surgical margin, involved by tumor
Distal pancreatic surgical margin, involved by tumor
Esophageal surgical margin, involved by tumor
Esophageal surgical margin, involved by tumor
Esophageal surgical margin, involved by tumor
Esophageal surgical margin, involved by tumor
Esophagus, distal surgical margin, involved by tumor
Esophagus, proximal surgical margin, involved by tumor
Esophagus, radial surgical margin, involved by tumor
Large intestine surgical margin, involved by tumor
Large intestine, deep radial surgical margin, involved by tumor
Large intestine, distal surgical margin, involved by tumor
Large intestine, proximal surgical margin, involved by tumor
Mesorectal specimen nearly completely intact
Pancreatic surgical margin, involved by tumor
Pancreatic surgical margin, involved by tumor
Pancreatic surgical margin, involved by tumor
Pancreatic surgical margin, involved by tumor
Pancreatic surgical margin, involved by tumor
Proximal pancreatic surgical margin, involved by tumor
Pseudolipomatosis
Rectum, deep surgical margin, focal, involved by tumor
Rectum, deep surgical margin, involved by tumor
Rectum, deep surgical margin, multifocal, involved by tumor
Rectum, inferior lateral surgical margin, involved by tumor
Rectum, lateral surgical margin, involved by tumor
Rectum, left lateral surgical margin, involved by tumor
Rectum, right lateral surgical margin, involved by tumor
Rectum, superior lateral surgical margin, involved by tumor
Rectum, unknown surgical margin, involved by tumor
Stomach surgical margin, involved by tumor
Stomach, distal surgical margin, involved by tumor
Stomach, mesenteric surgical margin, involved by tumor
Stomach, proximal surgical margin, involved by tumor
Surgical bile duct margin involved by malignant neoplasm
Surgical distal margin involved by malignant neoplasm
Surgical distal margin involved by tumor
Surgical distal pancreatic margin involved by malignant neoplasm
Surgical lesser omental margin involved by malignant neoplasm
Surgical mesenteric margin finding
Surgical mesenteric margin involved by malignant neoplasm
Surgical omental margin finding
Surgical pancreatic margin involved by malignant neoplasm
Surgical posterior margin involved by malignant neoplasm
Surgical posterior retroperitoneal pancreatic margin involved by malignant neoplasm
Surgical posterior retroperitoneal pancreatic margin involved by tumor
Surgical posterior retroperitoneal pancreatic margin involved by tumor
Surgical proximal pancreatic margin involved by malignant neoplasm
Upper aerodigestive tract surgical margin, involved by tumor

Clinical Classification

Clinical Category is Abnormal findings without diagnosis
CCSR Category Code: SYM017
Inpatient Default CCSR: Y - Yes, default inpatient assignment for principal diagnosis or first-listed diagnosis.
Outpatient Default CCSR: Y - Yes, default outpatient assignment for principal diagnosis or first-listed diagnosis.

Index to Diseases and Injuries References

The following annotation back-references for this diagnosis code are found in the injuries and diseases index. The Index to Diseases and Injuries is an alphabetical listing of medical terms, with each term mapped to one or more ICD-10-CM code(s).

- Abnormal, abnormality, abnormalities - See Also: Anomaly;
- - specimen
  - - digestive organs (peritoneal fluid) (saliva) - R85.9
    - - histology - R85.7

R85.7 is grouped with Diagnostic Related Groups - MS-DRG Mapping

Diagnostic Related Groups (DRGs) are a classification system used to group together diagnosis codes for the purpose of reimbursement and healthcare management. DRGs are used to standardize the way hospitals and other providers are paid for inpatient services. In this system patients are grouped together based on their principal diagnosis in areas referred to as Major Diagnostic Categories (MDC). Once a patient is assigned a particular diagnostic category, providers receive a predetermined payment rate for the services rendered. This reimbursement rate is often fixed and is meant to cover the cost of care for that patient. Reimbursement is also affected by the relative weight of a diagnostic related group based on the severity of a patient's illness and the associated cost of care during hospitalization.

Diagnostic related groups encourage healthcare providers to focus on quality and efficiency in patient care while managing costs effectively. The diagnosis code is present in the following groups for version MS-DRG V41.0 applicable from 10/01/2023 through 09/30/2024.

MS-DRG	MS-DRG Title	MCD	Relative Weight
947	SIGNS AND SYMPTOMS WITH MCC	23	1.2516
948	SIGNS AND SYMPTOMS WITHOUT MCC	23	0.801

The relative weight of a diagnostic related group determines the reimbursement rate based on the severity of a patient's illness and the associated cost of care during hospitalization.

Convert R85.7 to ICD-9-CM

ICD-9-CM Code: 792.4 - Abn findings-saliva
Approximate Flag - The approximate mapping means there is not an exact match between the ICD-10 and ICD-9 codes and the mapped code is not a precise representation of the original code.
ICD-9-CM Code: 792.9 - Abn find-body subst NEC
Approximate Flag - The approximate mapping means there is not an exact match between the ICD-10 and ICD-9 codes and the mapped code is not a precise representation of the original code.

Code History

FY 2024 - No Change, effective from 10/1/2023 through 9/30/2024
FY 2023 - No Change, effective from 10/1/2022 through 9/30/2023
FY 2022 - No Change, effective from 10/1/2021 through 9/30/2022
FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016. This was the first year ICD-10-CM was implemented into the HIPAA code set.

Footnotes

[1] Not chronic - A diagnosis code that does not fit the criteria for chronic condition (duration, ongoing medical treatment, and limitations) is considered not chronic. Some codes designated as not chronic are acute conditions. Other diagnosis codes that indicate a possible chronic condition, but for which the duration of the illness is not specified in the code description (i.e., we do not know the condition has lasted 12 months or longer) also are considered not chronic.