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.

Check R31.1 with the rest of the claim: free scrubber

Excludes1 inherited from the categories above R31.1

A category’s note binds every code beneath it.

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

Their own Excludes1 notes name this code, so the conflict is not listed above.

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

Risk adjustment

No CMS-HCC V28 category: this code does not change a RAF score.

Medicare coverage

R31.1 is named in 12 Medicare coverage policies: 12 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

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

Alphabetic index entries that lead here

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

Code history

Unchanged in every release from FY2024 to FY2027.