2027 ICD-10-CM Diagnosis Code R16Hepatomegaly and splenomegaly, not elsewhere classified

ICD-10-CM Codes›R00–R99›R10-R19›R16

ICD-10-CM R16
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

R16 is a non-billable ICD-10-CM category code for hepatomegaly and splenomegaly, not elsewhere classified, so it cannot be submitted on claims. Use a more specific code from this category instead, such as R16.0, R16.1, and R16.2. As a symptom code, it should not be used as a principal diagnosis once a related definitive diagnosis has been established.

Code Identity

ICD-10-CM Code
R16
Billable Status
No — Non-Billable Category
Code Describes
Hepatomegaly and splenomegaly, not elsewhere classified
Short Description
Hepatomegaly and splenomegaly, not elsewhere classified
Same as the full description in the CMS dataset.
Chapter
R10-R19
Symptoms and signs involving the digestive system and abdomen

Code Classification

ChapterR00–R99Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified
SectionR10-R19Symptoms and signs involving the digestive system and abdomen
CategoryR16Hepatomegaly and splenomegaly, not elsewhere classified
This CodeR16Hepatomegaly and splenomegaly, not elsewhere classified

Specific Coding for Hepatomegaly and splenomegaly, not elsewhere classifiedOverview

Non-specific codes like R16 require more characters. Use one of these billable codes instead:

  • Use R16.0 for Hepatomegaly, not elsewhere classified

  • Use R16.1 for Splenomegaly, not elsewhere classified

  • Use R16.2 for Hepatomegaly with splenomegaly, not elsewhere classified

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to R16: its own notes plus those printed at block R10-R19 and Chapter 18. A note printed at a category, block or chapter applies to every code under it.

Excludes2

Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.

From Block R10-R19 Symptoms and signs involving the digestive system and abdomen applies to 99 codes
  • congenital or infantile pylorospasm (Q40.0)
  • gastrointestinal hemorrhage (K92.0-K92.2)
  • intestinal obstruction (K56.-)
  • newborn gastrointestinal hemorrhage (P54.0-P54.3)
  • newborn intestinal obstruction (P76.-)
  • pylorospasm (K31.3)
  • signs and symptoms involving the urinary system (R30-R39)
  • symptoms referable to female genital organs (N94.-)
  • symptoms referable to male genital organs (N48-N50)
From Chapter 18 (R00-R99) Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified applies to 774 codes
  • abnormal findings on antenatal screening of mother (O28.-)
  • certain conditions originating in the perinatal period (P04-P96)
  • signs and symptoms classified in the body system chapters
  • signs and symptoms of breast (N63, N64.5)

Notes

General instructions on how these codes are used.

From Chapter 18 (R00-R99) Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified applies to 774 codes
  • This chapter includes symptoms, signs, abnormal results of clinical or other investigative procedures, and ill-defined conditions regarding which no diagnosis classifiable elsewhere is recorded.
  • Signs and symptoms that point rather definitely to a given diagnosis have been assigned to a category in other chapters of the classification. In general, categories in this chapter include the less well-defined conditions and symptoms that, without the necessary study of the case to establish a final diagnosis, point perhaps equally to two or more diseases or to two or more systems of the body. Practically all categories in the chapter could be designated 'not otherwise specified', 'unknown etiology' or 'transient'. The Alphabetical Index should be consulted to determine which symptoms and signs are to be allocated here and which to other chapters. The residual subcategories, numbered .8, are generally provided for other relevant symptoms that cannot be allocated elsewhere in the classification.
  • The conditions and signs or symptoms included in categories R00-R94 consist of:
  • (a) cases for which no more specific diagnosis can be made even after all the facts bearing on the case have been investigated;
  • (b) signs or symptoms existing at the time of initial encounter that proved to be transient and whose causes could not be determined;
  • (c) provisional diagnosis in a patient who failed to return for further investigation or care;
  • (d) cases referred elsewhere for investigation or treatment before the diagnosis was made;
  • (e) cases in which a more precise diagnosis was not available for any other reason;
  • (f) certain symptoms, for which supplementary information is provided, that represent important problems in medical care in their own right.

Source: CMS ICD-10-CM Tabular List. How to read instructional notes.

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Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2026No changes
FY 2027CurrentCurrent code set, no changesEffective October 1, 2026 through September 30, 2027.

Questions About R16Overview

What is the ICD-10 code for hepatomegaly and splenomegaly, not elsewhere classified?

R16 is the ICD-10-CM category for hepatomegaly and splenomegaly, not elsewhere classified, but it is a non-billable header: claims need a more specific code from this category, listed on this page.

Is R16 (Hepatomegaly and splenomegaly, not elsewhere classified) a billable code?

No. This is a category header that groups the codes for hepatomegaly and splenomegaly, not elsewhere classified, and headers cannot be submitted on claims. Claims for hepatomegaly and splenomegaly, not elsewhere classified need a more specific code from this category, such as R16.0, R16.1, and R16.2.

Can R16 be a principal diagnosis?

Use it with care. This is a symptom code, so once a definitive diagnosis explaining the hepatomegaly and splenomegaly, not elsewhere classified is established, that condition takes the principal position instead.