2027 ICD-10-CM Diagnosis Code R97.0Elevated carcinoembryonic antigen [CEA]
ICD-10-CM Codes›R00–R99›R97›R97
- Billable — Valid for Submission
- Not Chronic
R97.0 is a billable ICD-10-CM diagnosis code for elevated carcinoembryonic antigen [CEA]. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) 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
Code Classification
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- High carcinoembryonic antigen level
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to R97.0: its own notes plus those printed at Chapter 18. A note printed at a category, block or chapter applies to every code under it.
Excludes2
Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.
Notes
General instructions on how these codes are used.
- This chapter includes symptoms, signs, abnormal results of clinical or other investigative procedures, and ill-defined conditions regarding which no diagnosis classifiable elsewhere is recorded.
- Signs and symptoms that point rather definitely to a given diagnosis have been assigned to a category in other chapters of the classification. In general, categories in this chapter include the less well-defined conditions and symptoms that, without the necessary study of the case to establish a final diagnosis, point perhaps equally to two or more diseases or to two or more systems of the body. Practically all categories in the chapter could be designated 'not otherwise specified', 'unknown etiology' or 'transient'. The Alphabetical Index should be consulted to determine which symptoms and signs are to be allocated here and which to other chapters. The residual subcategories, numbered .8, are generally provided for other relevant symptoms that cannot be allocated elsewhere in the classification.
- The conditions and signs or symptoms included in categories R00-R94 consist of:
- (a) cases for which no more specific diagnosis can be made even after all the facts bearing on the case have been investigated;
- (b) signs or symptoms existing at the time of initial encounter that proved to be transient and whose causes could not be determined;
- (c) provisional diagnosis in a patient who failed to return for further investigation or care;
- (d) cases referred elsewhere for investigation or treatment before the diagnosis was made;
- (e) cases in which a more precise diagnosis was not available for any other reason;
- (f) certain symptoms, for which supplementary information is provided, that represent important problems in medical care in their own right.
Source: CMS ICD-10-CM Tabular List. How to read instructional notes.
Referenced in Other NotesGuidance
Instructional notes printed at other codes that name R97.0, its category, or a range that includes it.
Excludes2 1
These codes carry an Excludes2 note naming R97.0: its condition is not part of those codes, and both may be reported when the patient has both.
- Block R83-R89 Abnormal findings on examination of other body fluids, substances and tissues, without diagnosisabnormal tumor markers (R97.-) names R97.-, which includes this code
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Patient EducationClinical
CEA Test
A CEA test measures how much of a specific protein called carcinoembryonic antigen (CEA) you have. Healthy fetuses have high levels of this protein because CEA helps cells divide quickly, leading to more rapid growth. After birth, however, levels decrease quickly. Adults have very little if any CEA in their body.
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.
Code HistoryHistory
Questions About R97.0Overview
What is the ICD-10 code for elevated carcinoembryonic antigen [CEA]?
The ICD-10-CM code for elevated carcinoembryonic antigen [CEA] is R97.0 (sometimes written as R970). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
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, 2026 through September 30, 2027.
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 948, 947, with relative weights from 0.7833 to 1.2608 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.
