2026 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 2026 (October 1, 2025 through September 30, 2026) 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 with AIDS
- Large liver
- Liver edge palpable
- Liver edge palpable on inspiration
- Liver mass
- Liver palpable
- Mauriac's syndrome
- Schistosomal hepatomegaly
Tabular List NotesGuidance
Coding notes and annotation back-references applicable to this code.
Inclusion Terms
- Hepatomegaly NOS
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.
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
- liver - R16.0
External Cause of Injuries IndexGuidance
References for this code in the External Cause of Injuries Index.
- Hypertrophy, hypertrophic
- liver
- Mass
- liver
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
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
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, 2025 through September 30, 2026.
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 441, 442, 443, with relative weights from 0.6997 to 1.7947 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.
Footnotes
[1] Not chronic - A diagnosis code that does not fit the criteria for chronic condition (duration, ongoing medical treatment, and limitations) is considered not chronic. Some codes designated as not chronic are acute conditions. Other diagnosis codes that indicate a possible chronic condition, but for which the duration of the illness is not specified in the code description (i.e., we do not know the condition has lasted 12 months or longer) also are considered not chronic.
