2026 ICD-10-CM Diagnosis Code S36.030DSuperficial (capsular) laceration of spleen, subsequent encounter
S36.030D is a billable ICD-10-CM diagnosis code for superficial (capsular) laceration of spleen, subsequent encounter. The 7th character D marks it as a subsequent encounter code, used during routine care in the healing or recovery phase. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 949 through 950. The code is exempt from POA reporting. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Internal organ injury, subsequent encounter.
Code Identity
Code Classification
Present on Admission (POA)Billing
S36.030D is exempt from POA reporting on inpatient claims to general acute care hospitals. Review other POA exempt codes.
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Capsular tear of spleen
- Capsular tear without major disruption of parenchyma of spleen AND with open wound in abdominal cavity
- Injury of spleen with open wound into abdominal cavity
- Laceration of spleen
- Minor laceration of spleen
- Open injury of spleen
Coding GuidelinesGuidance
The appropriate 7th character is to be added to each code from block Injury of intra-abdominal organs (S36). Use the following options for the applicable episode of care:
- A - initial encounter
- D - subsequent encounter
- S - sequela
Source: ICD-10-CM Official Guidelines for Coding and Reporting, FY 2026, published by CMS and the National Center for Health Statistics.
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Patient EducationClinical
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.
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert S36.030D to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About S36.030DOverview
Is S36.030D (Superficial (capsular) laceration of spleen) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report superficial (capsular) laceration of spleen, subsequent encounter on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
What does the 7th character D in S36.030D mean?
The final character D marks a subsequent encounter: use it for routine care while the superficial (capsular) laceration of spleen is healing, after active treatment has ended.
What MS-DRG does S36.030D group to?
When superficial (capsular) laceration of spleen, subsequent encounter is the principal diagnosis on an inpatient stay, it groups to MS-DRG 949, 950, with relative weights from 0.6277 to 1.1897 depending on complications. Higher weights mean higher Medicare reimbursement.
Is S36.030D exempt from POA reporting?
Yes. CMS lists this code among those exempt from present on admission reporting, so hospitals do not assign a POA indicator for superficial (capsular) laceration of spleen, subsequent encounter on inpatient claims.
What is the ICD-9 equivalent of S36.030D?
Under the General Equivalence Mappings, superficial (capsular) laceration of spleen, subsequent encounter converts to ICD-9-CM V58.89 (other specfied aftercare). 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.
