R31.0 — Gross hematuria
R31.0 is a billable, specific ICD-10-CM code for gross hematuria. It is valid for submission on a claim.
Risk adjustment
R31.0 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.
Medicare coverage
R31.0 is named in 11 Medicare coverage policies — 11 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A53095Billing and Coding: Lab: Bladder/Urothelial Tumor Markers
- A55028Billing and Coding: Lab: Bladder/Urothelial Tumor Markers
- A55336Billing and Coding: Retroperitoneal Ultrasound
- A56421Billing and Coding: CT of the Abdomen and Pelvis
How R31.0 is indexed
Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to R31.0.
- Hematuria›gross
Related codes at this level
Codes that share R31. If R31.0 is not quite right, the correct code is usually one of these.
Questions about R31.0
- Is R31.0 a billable ICD-10-CM code?
- Yes. R31.0 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does R31.0 sit in the tabular list?
- Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99), in the block Symptoms and signs involving the genitourinary system (R30-R39).