Is R97 a billable ICD-10-CM code?

No. R97 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does R97 sit in the tabular list?

Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99), in the block Abnormal tumor markers (R97).

R97

R97 — Abnormal tumor markers

Non-billable headerICD-10-CM

R97 is a non-billable header ICD-10-CM code for abnormal tumor markers. It cannot be billed on its own: choose one of the more specific child codes below.

Inclusion terms

Alternative wordings a physician may use in the chart for this same code.

Elevated tumor associated antigens [TAA]
Elevated tumor specific antigens [TSA]

Risk adjustment

R97 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 R97

4 child codes. Green means billable.

Questions about R97

Is R97 a billable ICD-10-CM code?: No. R97 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does R97 sit in the tabular list?: Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99), in the block Abnormal tumor markers (R97).