R92.2 — Inconclusive mammogram
R92.2 is a billable, specific ICD-10-CM code for inconclusive mammogram. It is valid for submission on a claim.
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Inconclusive mammogram NEC
- Inconclusive mammography NEC
Other codes that can never be billed with R92.2
These codes carry an Excludes1 note pointing at R92.2. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading R92.2 alone.
- Z12.31Encounter for screening mammogram for malignant neoplasm of breast
Risk adjustment
R92.2 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
R92.2 is named in 4 Medicare coverage policies — 4 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A52849Billing and Coding: Breast Imaging: Breast Echography (Sonography)/Breast MRI/Ductography
- A56448Billing and Coding: Breast Imaging Mammography/Breast Echography (Sonography)/Breast MRI/Ductography
- A56448Billing and Coding: Breast Imaging Mammography/Breast Echography (Sonography)/Breast MRI/Ductography
- A56580Billing and Coding: Computerized Axial Tomography (CT), Thorax
How R92.2 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 R92.2.
- Inconclusive›mammogram
- Findings, abnormal, inconclusive, without diagnosis›mammogram NEC›inconclusive result
Related codes at this level
Codes that share R92. If R92.2 is not quite right, the correct code is usually one of these.
Questions about R92.2
- Is R92.2 a billable ICD-10-CM code?
- Yes. R92.2 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does R92.2 sit in the tabular list?
- Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99), in the block Abnormal findings on diagnostic imaging and in function studies, without diagnosis (R90-R94).