2027 ICD-10-CM Diagnosis Code R16.0Hepatomegaly, not elsewhere classified
ICD-10-CM Codes›R00–R99›R10-R19›R16
- Billable — Valid for Submission
- Not Chronic
R16.0 is a billable ICD-10-CM diagnosis code for hepatomegaly, not elsewhere classified. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 441 through 443. As a symptom code, it should not be used as a principal diagnosis once a related definitive diagnosis has been established. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Abdominal pain and other digestive/abdomen signs and symptoms.
Code Identity
Code Classification
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Enlargement of liver co-occurrent with human immunodeficiency virus infection
- Hepatic schistosomiasis
- Hepatomegaly due to gammaherpesviral mononucleosis
- Hepatomegaly with AIDS
- Large liver
- Liver edge palpable
- Liver edge palpable on inspiration
- Liver mass
- Liver palpable
- Mauriac's syndrome
- Schistosomal hepatomegaly
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to R16.0: 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.
Applicable To
Conditions this code is used for: synonyms of the title or, for "other specified" codes, the conditions assigned to it. The list is not exhaustive.
- Hepatomegaly NOS
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.
- 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)
Notes
General instructions on how these codes are used.
- 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.
Referenced in Other NotesGuidance
Instructional notes printed at other codes that name R16.0, its category, or a range that includes it.
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Clinical InformationClinical
Hepatomegaly
enlargement of the liver.
Patient EducationClinical
Liver Diseases
Your liver is the largest organ inside your body. It helps your body digest food, store energy, and remove poisons.
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert R16.0 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About R16.0Overview
What is the ICD-10 code for hepatomegaly, not elsewhere classified?
The ICD-10-CM code for hepatomegaly, not elsewhere classified is R16.0 (sometimes written as R160). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is R16.0 (Hepatomegaly and splenomegaly, not elsewhere classified) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report hepatomegaly, not elsewhere classified on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does R16.0 group to?
When hepatomegaly, not elsewhere classified is the principal diagnosis on an inpatient stay, it groups to MS-DRG 442, 441, 443, with relative weights from 0.6890 to 1.8226 depending on complications. Higher weights mean higher Medicare reimbursement.
Can R16.0 be a principal diagnosis?
Use it with care. This is a symptom code, so once a definitive diagnosis explaining the hepatomegaly, not elsewhere classified is established, that condition takes the principal position instead.
What is the ICD-9 equivalent of R16.0?
Under the General Equivalence Mappings, hepatomegaly, not elsewhere classified converts to ICD-9-CM 789.1 (hepatomegaly). The mapping is approximate, so confirm the match fits the documentation.
