ICD-10-CM Code R16.1

Splenomegaly, not elsewhere classified

Version 2020 Billable Code No Valid Principal Dx

Valid for Submission

R16.1 is a billable code used to specify a medical diagnosis of splenomegaly, not elsewhere classified. The code is valid for the year 2020 for the submission of HIPAA-covered transactions. The ICD-10-CM code R16.1 might also be used to specify conditions or terms like infection of spleen, infection of spleen, mass of spleen, o/e - gross splenomegaly, o/e - moderate splenomegaly, o/e - painful splenomegaly, etc

According to ICD-10-CM guidelines this code should not to be used as a principal diagnosis code when a related definitive diagnosis has been established.

ICD-10:R16.1
Short Description:Splenomegaly, not elsewhere classified
Long Description:Splenomegaly, not elsewhere classified

Tabular List of Diseases and Injuries

The Tabular List of Diseases and Injuries is a list of ICD-10 codes, organized "head to toe" into chapters and sections with guidance for inclusions, exclusions, descriptions and more. The following references are applicable to the code R16.1:

Inclusion Terms

Inclusion Terms
These terms are the conditions for which that code is to be used. The terms may be synonyms of the code title, or, in the case of "other specified" codes, the terms are a list of the various conditions assigned to that code. The inclusion terms are not necessarily exhaustive. Additional terms found only in the Alphabetic Index may also be assigned to a code.
  • Splenomegaly NOS

Index to Diseases and Injuries

The Index to Diseases and Injuries is an alphabetical listing of medical terms, with each term mapped to one or more ICD-10 code(s). The following references for the code R16.1 are found in the index:


Synonyms

The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:

  • Infection of spleen
  • Infection of spleen
  • Mass of spleen
  • O/E - gross splenomegaly
  • O/E - moderate splenomegaly
  • O/E - painful splenomegaly
  • O/E - spleen just palpable
  • O/E - splenomegaly
  • On examination - spleen palpable
  • Optic nerve edema, splenomegaly syndrome
  • Pain of lymphoreticular structure
  • Schistosomal splenomegaly
  • Schistosomal splenomegaly
  • Spleen palpable
  • Spleen palpable below costal margin
  • Spleen palpable in right lateral position
  • Spleen palpable on inspiration
  • Splenic notch palpable
  • Splenic schistosomal giant cell lymphoma
  • Splenomegaly
  • Splenomegaly co-occurrent and due to storage disease
  • Splenomegaly co-occurrent with human immunodeficiency virus infection
  • Tip of spleen palpable

Diagnostic Related Groups

The ICD-10 code R16.1 is grouped in the following groups for version MS-DRG V37.0 What are Diagnostic Related Groups?
The Diagnostic Related Groups (DRGs) are a patient classification scheme which provides a means of relating the type of patients a hospital treats. The DRGs divides all possible principal diagnoses into mutually exclusive principal diagnosis areas referred to as Major Diagnostic Categories (MDC).
applicable from 10/01/2020 through 09/30/2020.

  • 814 - RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH MCC
  • 815 - RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH CC
  • 816 - RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITHOUT CC/MCC

Convert R16.1 to ICD-9

  • 789.2 - Splenomegaly (Approximate Flag)

Code Classification

  • Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00–R99)
    • Symptoms and signs involving the digestive system and abdomen (R10-R19)
      • Hepatomegaly and splenomegaly, not elsewhere classified (R16)

Code History

  • FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016
    (First year ICD-10-CM implemented into the HIPAA code set)
  • FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
  • FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
  • FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
  • FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020

Information for Patients


Spleen Diseases

Your spleen is an organ above your stomach and under your ribs on your left side. It is about as big as your fist. The spleen is part of your lymphatic system, which fights infection and keeps your body fluids in balance. It contains white blood cells that fight germs. Your spleen also helps control the amount of blood in your body, and destroys old and damaged cells.

Certain diseases might cause your spleen to swell. You can also damage or rupture your spleen in an injury, especially if it is already swollen. If your spleen is too damaged, you might need surgery to remove it. You can live without a spleen. Other organs, such as your liver, will take over some of the spleen's work. Without a spleen, however, your body will lose some of its ability to fight infections.


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