2026 ICD-10-CM Diagnosis Code R97.0Elevated carcinoembryonic antigen [CEA]

ICD-10-CM Codes›R00–R99›R97›R97

ICD-10-CM R97.0
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

R97.0 is a billable ICD-10-CM diagnosis code for elevated carcinoembryonic antigen [CEA]. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 947 through 948. As a symptom code, it should not be used as a principal diagnosis once a related definitive diagnosis has been established. Coders also document this condition as high carcinoembryonic antigen level. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Abnormal findings without diagnosis.

Code Identity

ICD-10-CM Code
R97.0
Billable Status
Yes — Valid for Submission
Code Describes
Elevated carcinoembryonic antigen [CEA]
Short Description
Elevated carcinoembryonic antigen [CEA]
Same as the full description in the CMS dataset.
Parent Code
R97
Abnormal tumor markers

Code Classification

ChapterR00–R99Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified
SectionR97Abnormal tumor markers
CategoryR97Abnormal tumor markers
This CodeR97.0Elevated carcinoembryonic antigen [CEA]

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • High carcinoembryonic antigen level

Index to Diseases and InjuriesGuidance

Alphabetical index entries that point to this code.

External Cause of Injuries IndexGuidance

References for this code in the External Cause of Injuries Index.

    • Elevated, elevation
      • carcinoembryonic antigen [CEA]

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR SYM017
Abnormal findings without diagnosis
Default principal diagnosis: inpatient Yes · outpatient Yes

Patient EducationClinical

CEA Test

CEA stands for carcinoembryonic antigen. CEA is a protein that is a type of "tumor marker." Tumor markers are substances that are often made by cancer cells or by normal cells in response to cancer.

Read the full article at MedlinePlus

Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.

Convert R97.0 to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
795.81 Elev ca-embryoic antigen
Exact Match The mapping is direct, with no qualifiers.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2025No changes
FY 2026CurrentCurrent code set, no changesEffective October 1, 2025 through September 30, 2026.

Questions About R97.0Overview

Is R97.0 (Abnormal tumor markers) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report elevated carcinoembryonic antigen [CEA] on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

What MS-DRG does R97.0 group to?

When elevated carcinoembryonic antigen [CEA] is the principal diagnosis on an inpatient stay, it groups to MS-DRG 947, 948, with relative weights from 0.8005 to 1.2694 depending on complications. Higher weights mean higher Medicare reimbursement.

Can R97.0 be a principal diagnosis?

Use it with care. This is a symptom code, so once a definitive diagnosis explaining the elevated carcinoembryonic antigen [CEA] is established, that condition takes the principal position instead.

What is the ICD-9 equivalent of R97.0?

Under the General Equivalence Mappings, elevated carcinoembryonic antigen [CEA] converts to ICD-9-CM 795.81 (elev ca-embryoic antigen). The mapping is a direct match.

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.