New code · FY2026
Billable: use this code on claims.
- New code, effective October 1, 2025 (FY2026).
Code breakdown
R10.21
- R10CategoryAbdominal and pelvic pain
- 2Character 4Pelvic and perineal pain
- 1Character 5Pelvic and perineal pain right side
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
R10.21 is listed as a covered diagnosis in 24 Medicare billing and coding articles:
- A52453 Billing and Coding: Luteinizing Hormone-Releasing Hormone (LHRH) Analogs
- A55028 Billing and Coding: Lab: Bladder/Urothelial Tumor Markers
- A55336 Billing and Coding: Retroperitoneal Ultrasound
- A55937 Billing and Coding: Diagnostic Colonoscopy
- A56034 Billing and Coding: Nerve Blockade for Treatment of Chronic Pain and Neuropathy
- A56421 Billing and Coding: CT of the Abdomen and Pelvis
- A56456 Billing and Coding: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy
- A56461 Billing and Coding: Endoscopy by Capsule
- A56607 Billing and Coding: Continuous Peripheral Nerve Blocks (CPNB)
- A56632 Billing and Coding: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy
…and 14 more. Check the coverage tool for your CPT code.
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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.