R10.20: Pelvic and perineal pain unspecified side

New code · FY2026

Billable: use this code on claims.

• New code, effective October 1, 2025 (FY2026).

Code breakdown

Coding notes

Excludes1 (from R10.2)

• vulvodynia (N94.81)

Excludes2 (from R10.2)

• pain localized to other parts of lower abdomen (R10.3-)
• pain localized to upper abdomen (R10.1-)

Excludes1 (from R10)

• renal colic (N23)

Excludes2 (from R10)

• costovertebral (angle) tenderness (R39.85)
• dorsalgia (M54.-)
• flatulence and related conditions (R14.-)

Medicare coverage

R10.20 is listed as a covered diagnosis in 11 Medicare billing and coding articles:

• A55028 Billing and Coding: Lab: Bladder/Urothelial Tumor Markers
• A55336 Billing and Coding: Retroperitoneal Ultrasound
• A56421 Billing and Coding: CT of the Abdomen and Pelvis
• A56607 Billing and Coding: Continuous Peripheral Nerve Blocks (CPNB)
• A57326 Billing and Coding: Electrocardiograms
• A57342 Billing and Coding: Diagnostic and Therapeutic Colonoscopy
• A57452 Billing and Coding: Peripheral Nerve Blocks
• A58710 Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing
• A58720 Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing
• A58747 Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing

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All FY2026 ICD-10-CM changes

ICD-10-CM codes and descriptions are from the CMS and NCHS code files. Coverage is from the CMS Medicare Coverage Database billing and coding articles.