Diagnosis Code R97.21
Information for Medical Professionals
The following edits are applicable to this code:
Adult diagnoses - Adult. Age range is 15–124 years inclusive (e.g., senile delirium, mature cataract).
Diagnoses for males only - Diagnoses for males only.
Questionable admission codes - Some diagnoses are not usually sufficient justification for admission to an acute care hospital. For example, if a patient is given code R030 for elevated blood pressure reading, without diagnosis of hypertension, then the patient would have a questionable admission, since elevated blood pressure reading is not normally sufficient justification for admission to a hospital.
Diagnostic Related Groups
The diagnosis code R97.21 is grouped in the following Diagnostic Related Group(s) (MS-DRG V35.0)
Convert to ICD-9
- 790.93 - Elvtd prstate spcf antgn (Approximate Flag)
This code replaces the following previously assigned ICD-10 code(s) listed below:
- R97.2 - Elevated prostate specific antigen [PSA]
General Equivalence Map Definitions
The ICD-10 and ICD-9 GEMs are used to facilitate linking between the diagnosis codes in ICD-9-CM and the new ICD-10-CM code set. The GEMs are the raw material from which providers, health information vendors and payers can derive specific applied mappings to meet their needs.
- Approximate Flag - The approximate flag is on, indicating that the relationship between the code in the source system and the code in the target system is an approximate equivalent.
- No Map Flag - The no map flag indicates that a code in the source system is not linked to any code in the target system.
- Combination Flag - The combination flag indicates that more than one code in the target system is required to satisfy the full equivalent meaning of a code in the source system.
Present on Admission
The Present on Admission (POA) indicator is used for diagnosis codes included in claims involving inpatient admissions to general acute care hospitals. POA indicators must be reported to CMS on each claim to facilitate the grouping of diagnoses codes into the proper Diagnostic Related Groups (DRG). CMS publishes a listing of specific diagnosis codes that are exempt from the POA reporting requirement.