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Home/Diagnosis/ICD-10 Coding for Enlarged Spleen

ICD-10 Coding for Enlarged Spleen

R16.1
D73.0

Complete ICD-10-CM coding and documentation guide for icd-10 coding for enlarged spleen includes clinical validation requirements, medical necessity guidelines, and coding policies.

Also Known as:
Splenomegaly
Spleen Enlargement
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Key Information: ICD-10 Coding for Enlarged Spleen

Essential facts and insights about ICD-10 Coding for Enlarged Spleen

Use ICD-10 code R16.1 for splenomegaly, not elsewhere classified, ensuring proper documentation in clinical notes.

Primary ICD-10-CM Codes

Splenomegaly, not elsewhere classified

Billable Code
R16.1
Billable

Diagnostic Criteria

clinical_criteria:
  • • Spleen size ≥13 cm on imaging
coding_criteria:
  • • No identifiable underlying cause

Applicable To

  • • Isolated spleen enlargement

Important Notes

  • • Ensure documentation includes spleen size and method of confirmation.

Hypersplenism

Billable Code
D73.0
Billable

Diagnostic Criteria

clinical_validation_requirements:
  • • CBC showing cytopenias
  • • Bone marrow biopsy ruling out primary disorders

Applicable To

  • • Splenomegaly with cytopenias

Important Notes

  • • Link to underlying hematologic condition if applicable.
Ancillary Codes

Additional codes that may be used with this diagnosis

D73.0

Use when splenomegaly is due to hypersplenism.

Additional codes that should be used in conjunction with the main diagnosis codes when applicable.

Frequently Asked Questions

What is the ICD-10 code for an enlarged spleen?

The ICD-10 code for an enlarged spleen not elsewhere classified is R16.1. It is used when no underlying cause is identified.

How is splenomegaly documented?

Splenomegaly should be documented with spleen size and confirmation method, such as imaging or detailed physical exam.

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