2025 ICD-10-CM code R87.811
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Symptoms, signs, and abnormal clinical and laboratory findings - Abnormal findings on examination of other body fluids, substances and tissues, without diagnosis (R83-R89) Chapter 18: Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99) Feed
Positive vaginal high-risk human papillomavirus (HPV) DNA test.
Modifiers might be required depending on the circumstances of the test, such as the location and type of service.Consult the relevant coding guidelines and payer specific rules for accurate modifier application.
Medical necessity for this code is established by the need for HPV screening based on established guidelines (e.g., age, sexual activity, prior abnormal Pap smears).The test helps identify high-risk HPV types that increase the risk of precancerous or cancerous conditions, thus justifying the procedure.
The clinical responsibility for this code rests with the healthcare professional who orders and interprets the HPV DNA test. This includes obtaining the patient's history, performing or overseeing the collection of the vaginal sample, and interpreting the test results to determine the appropriate next steps in management (e.g., further testing, referral to a specialist).
- Chapter 18: Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99)
- R87.811 is under the broader category R87.8, which encompasses abnormal findings in secretions and smears from the cervix, vagina, and vulva.
In simple words: This code means a lab test showed high-risk types of the human papillomavirus (HPV) in a sample from the vagina.High-risk HPV types can increase the chance of certain cancers.
This code signifies a positive result for a deoxyribonucleic acid (DNA) test detecting high-risk types of human papillomavirus (HPV) in a vaginal specimen.The test identifies the presence of HPV DNA associated with a higher risk of developing cervical, vaginal, vulvar, anal, penile, and oropharyngeal cancers. This code is specifically for vaginal samples and should not be used for other sites.
Example 1: A 30-year-old woman presents for a routine Pap smear and HPV test. The vaginal HPV DNA test returns positive for high-risk HPV types. Code R87.811 is assigned., A 25-year-old woman with abnormal Pap smear results undergoes colposcopy with a directed biopsy. The biopsy reveals no cancerous changes, but a high-risk HPV DNA test of vaginal fluid collected during the procedure is positive. R87.811 is applied., During a routine gynecological exam, a vaginal swab is collected for an HPV DNA test as part of cancer screening. The test results are positive for high-risk HPV. Code R87.811 is utilized in conjunction with relevant codes for additional testing or treatment, if indicated.
The documentation must include:
** This code is specific to vaginal samples.For cervical samples, use R87.810.Always consult the latest ICD-10-CM coding guidelines and payer-specific instructions for accurate coding and reimbursement.
- Payment Status: Active
- Specialties:Gynecology, Obstetrics, Oncology
- Place of Service:Office, Outpatient Hospital, Ambulatory Surgical Center