Is R31.1 a billable ICD-10-CM code?

Yes. R31.1 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does R31.1 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).

What cannot be coded together with R31.1?

R31.1 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above R31.1 (R31) and apply to it just the same.

R31.1

R31.1 — Benign essential microscopic hematuria

Billable / specific codeICD-10-CM

R31.1 is a billable, specific ICD-10-CM code for benign essential microscopic hematuria. It is valid for submission on a claim.

Excludes1 inherited from the categories above R31.1

These are not written on R31.1, but they bind it: a note on a category applies to every code beneath it. Billing R31.1 with anything listed here is a denial.

Written on R31 — Hematuria

hematuria included with underlying conditions, such as:
acute cystitis with hematuria (N30.01)
recurrent and persistent hematuria in glomerular diseases (N02.-)

Other codes that can never be billed with R31.1

These codes carry an Excludes1 note pointing at R31.1. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading R31.1 alone.

N02Recurrent and persistent hematuria
N42.1Congestion and hemorrhage of prostate

Risk adjustment

R31.1 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

R31.1 is named in 12 Medicare coverage policies — 12 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A52986Billing and Coding: Biomarkers for Oncology
A53095Billing and Coding: Lab: Bladder/Urothelial Tumor Markers
A55028Billing and Coding: Lab: Bladder/Urothelial Tumor Markers
A55336Billing and Coding: Retroperitoneal Ultrasound

How R31.1 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 R31.1.

Hematuria›benign›essential microscopic
Hematuria›microscopic NEC›benign essential

Code history

R31.1 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Related codes at this level

Codes that share R31. If R31.1 is not quite right, the correct code is usually one of these.

Questions about R31.1

Is R31.1 a billable ICD-10-CM code?: Yes. R31.1 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does R31.1 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).
What cannot be coded together with R31.1?: R31.1 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above R31.1 (R31) and apply to it just the same.