2024 ICD-10-CM Diagnosis Code R93.811

Abnormal radiologic findings on diagnostic imaging of right testicle

ICD-10-CM Code:: R93.811
Short Description:: Abnormal radiologic findings on dx imaging of right testicle
Is Billable?: Yes - Valid for Submission
Chronic Condition Indicator: ^[1]: Not chronic
Code Navigator:

1. Clinical Classification
2. Tabular List of Diseases and Injuries
3. Code Edits
4. Diagnostic Related Groups - MS-DRG Mapping
5. Replacement Code
6. Patient Education
7. Other Codes Used Similar Conditions
8. Code History

Code Classification

Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified
(R00–R99)
- Abnormal findings on diagnostic imaging and in function studies, without diagnosis
  (R90-R94)
  - Abnormal findings on diagnostic imaging of body structures
    (R93)

R93.811 is a billable diagnosis code used to specify a medical diagnosis of abnormal radiologic findings on diagnostic imaging of right testicle. The code is valid during the current fiscal year for the submission of HIPAA-covered transactions from October 01, 2023 through September 30, 2024.

This code is applicable to male patients only. It is clinically and virtually impossible to use this code on a non-male patient.

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.

Clinical Classification

Clinical Category:: 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.

Code Edits

The Medicare Code Editor (MCE) detects and reports errors in the coding of claims data. The following ICD-10-CM Code Edits are applicable to this code:

Diagnoses for males only - The Medicare Code Editor detects inconsistencies between a patient’s sex and any diagnosis on the patient’s record, these edits apply to MALES only .

R93.811 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
729	OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITH CC/MCC	12	1.0039
730	OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC	12	0.6216

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.

Replacement Code

R93811 replaces the following previously assigned ICD-10-CM code(s):

R93.8 - Abnormal findings on diagnostic imaging of body structures

Patient Education

Testicular Disorders

Testicles, or testes, make male hormones and sperm. They are two egg-shaped organs inside the scrotum, the loose sac of skin behind the penis. It's easy to injure your testicles because they are not protected by bones or muscles. Men and boys should wear athletic supporters when they play sports.

You should examine your testicles monthly and seek medical attention for lumps, redness, pain or other changes. Testicles can get inflamed or infected. They can also develop cancer. Testicular cancer is rare and highly treatable. It usually happens between the ages of 15 and 40.

[Learn More in MedlinePlus]

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

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.