Abnormal tumor markers (R97) ICD-10-CM
The R97 code range covers abnormal tumor markers with 7 ICD-10-CM diagnosis codes. 5 of them are billable and valid for claim submission in fiscal year 2026, and the category headers group them but cannot themselves be billed.
Inclusion Terms
These terms are the conditions for which that code is to be used. The terms may be synonyms of the code title, or, in the case of "other specified" codes, the terms are a list of the various conditions assigned to that code. The inclusion terms are not necessarily exhaustive. Additional terms found only in the Alphabetic Index may also be assigned to a code.
- Elevated tumor associated antigens [TAA]
- Elevated tumor specific antigens [TSA]
Codes in the R97 Range 7 codes · 5 billable
- R97 Abnormal tumor markersNon-billable
- R97.0 Elevated carcinoembryonic antigen [CEA]
- R97.1 Elevated cancer antigen 125 [CA 125]
- R97.2 Elevated prostate specific antigen [PSA]Non-billable
- R97.20 Elevated prostate specific antigen [PSA]
- R97.21 Rising PSA following treatment for malignant neoplasm of prostate
- R97.8 Other abnormal tumor markers
About the R97 Code Range
ICD-10 code R97 and its subcodes classify various abnormal tumor marker test results when a definitive diagnosis is not yet established. These codes are used primarily to document elevated levels of specific tumor markers detected through laboratory tests.
This range includes codes for elevated carcinoembryonic antigen levels, such as R97.0—also known as high carcinoembryonic antigen or CEA—which can indicate various cancers or benign conditions. R97.1 refers to elevated cancer antigen 125 (CA 125), a marker often used in monitoring ovarian cancer. The R97.2 series covers elevated prostate specific antigen (PSA) levels, including R97.20 for PSA outside the normal range and R97.21 for rising PSA after prostate cancer treatment. Other tumor markers that do not fit these categories fall under R97.8, which includes markers like cancer antigen 19-9, ovarian or endometrial cancer susceptibility markers, and high tumor mutational burden. These codes help healthcare providers track abnormal tumor marker findings separate from confirmed diagnoses, supporting further diagnostic evaluation and monitoring.
Questions About This Page
How many billable codes are in the R97 range?
Of the 7 codes in this range, 5 are billable and valid for claim submission from October 1, 2025 through September 30, 2026. Category header codes group them but cannot be reported on claims.
What does the R97 range classify?
The range classifies abnormal tumor markers. Each code links to its own reference page with billing status, MS-DRG grouping, coding notes, and clinical information.
Related References
Source: CMS FY 2026 ICD-10-CM Tabular List and order file, effective October 1, 2025 through September 30, 2026.
