Is R85.61 a billable ICD-10-CM code?

No. R85.61 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does R85.61 sit in the tabular list?

Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99), in the block Abnormal findings on examination of other body fluids, substances and tissues, without diagnosis (R83-R89).

What cannot be coded together with R85.61?

R85.61 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.

R85.61

R85.61 — Abnormal cytologic smear of anus

Non-billable headerICD-10-CM

R85.61 is a non-billable header ICD-10-CM code for abnormal cytologic smear of anus. It cannot be billed on its own: choose one of the more specific child codes below.

Excludes1 — never code together

These conditions cannot occur together. Billing both on the same encounter is a denial.

abnormal cytological findings in specimens from other digestive organs and abdominal cavity (R85.69)
carcinoma in situ of anus (histologically confirmed) (D01.3)
anal intraepithelial neoplasia I [AIN I] (K62.82)
anal intraepithelial neoplasia II [AIN II] (K62.82)
anal intraepithelial neoplasia III [AIN III] (D01.3)
dysplasia (mild) (moderate) of anus (histologically confirmed) (K62.82)
severe dysplasia of anus (histologically confirmed) (D01.3)

Excludes2 — not included here, but may coexist

The excluded condition is not part of this code, but a patient can have both. You may code both.

anal high risk human papillomavirus (HPV) DNA test positive (R85.81)
anal low risk human papillomavirus (HPV) DNA test positive (R85.82)

Other codes that can never be billed with R85.61

These codes carry an Excludes1 note pointing at R85.61. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading R85.61 alone.

K62.82Dysplasia of anus

Risk adjustment

R85.61 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.

Code to one of these instead R85.61

9 child codes. Green means billable.

Related codes at this level

Codes that share R85.6. If R85.61 is not quite right, the correct code is usually one of these.

R85.69Abnormal cytological findings in specimens from other digestive organs and abdominal cavity

Questions about R85.61

Is R85.61 a billable ICD-10-CM code?: No. R85.61 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does R85.61 sit in the tabular list?: Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99), in the block Abnormal findings on examination of other body fluids, substances and tissues, without diagnosis (R83-R89).
What cannot be coded together with R85.61?: R85.61 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.