Splenomegaly ICD-10-CM Codes | 2023

What ICD-10 Codes are Used for Splenomegaly?

Splenomegaly is characterized by an enlarged spleen, often indicative of an underlying medical condition. Proper diagnosis and coding are essential for accurate medical records and effective treatment. Here are some commonly used ICD-10 codes for splenomegaly, along with their clinical descriptions:

R16.1: Hepatomegaly, not elsewhere classified - This code is used when an enlarged liver and splenomegaly are present. It indicates an abnormal increase in liver size, possibly caused by various factors such as liver diseases or infections.

D73.0: Hypersplenism - This code is used when splenomegaly is associated with the overactive functioning of the spleen, leading to excessive destruction of blood cells. It often occurs as a secondary condition in various hematological disorders.

D69.59: Other secondary thrombocytopenia - This code is used when splenomegaly is associated with decreased platelet count due to a secondary cause. It indicates a condition where the spleen plays a role in the destruction or sequestration of platelets.

D59.4: Other non-autoimmune hemolytic anemias - This code is used when splenomegaly is associated with the accelerated destruction of red blood cells due to a non-autoimmune cause. It denotes a condition where the spleen contributes to the breakdown of red blood cells.

K65.8: Other peritonitis - This code is used when splenomegaly is accompanied by inflammation of the peritoneum, the lining of the abdominal cavity. It indicates an infection or inflammation affecting the peritoneum, which various factors, including underlying diseases, can cause.

D47.3: Essential thrombocythemia - This code is used when splenomegaly is present in conjunction with an increased number of platelets in the blood. It denotes a chronic myeloproliferative disorder characterized by the overproduction of platelets, which can lead to an enlarged spleen.

D73.1: Felty's syndrome - This code is used when splenomegaly is accompanied by rheumatoid arthritis and a decreased white blood cell count. It indicates a rare complication of rheumatoid arthritis, characterized by an enlarged spleen and other symptoms.

C88.8: Other specified malignant neoplasms of lymphoid, hematopoietic, and related tissues - This code is used when splenomegaly is caused by a specific malignant tumor originating from lymphoid, hematopoietic, or related tissues. It denotes a secondary condition related to cancerous growth in the body.

D73.81: Macrophage activation syndrome - This code is used when splenomegaly is associated with a severe, potentially life-threatening condition characterized by an overactive immune system. It often occurs as a complication of certain rheumatic or autoimmune disorders.

K70.30: Alcoholic cirrhosis of liver without ascites - This code is used when splenomegaly is present as a result of alcoholic cirrhosis of the liver. It indicates an advanced stage of liver disease caused by long-term alcohol abuse, leading to liver scarring and dysfunction.

Which Splenomegaly ICD codes are Billable? 

R16.1: Hepatomegaly, not elsewhere classified - No. This code specifically pertains to hepatomegaly (enlarged liver) and not splenomegaly (enlarged spleen).

D73.0: Hypersplenism - Yes. Hypersplenism involves an enlarged spleen and is a billable code when it is the primary reason for the encounter or significantly impacts patient care and management.

D69.59: Other secondary thrombocytopenia - Yes. Secondary thrombocytopenia with splenomegaly is a billable code when it is the primary reason for the encounter or requires specific attention and treatment.

D59.4: Other non-autoimmune hemolytic anemias - Yes. Non-autoimmune hemolytic anemia with splenomegaly is billable as it represents a distinct condition requiring medical intervention.

K65.8: Other peritonitis - Yes. If the encounter primarily focuses on peritonitis with associated splenomegaly, this code can be billed to represent the condition and facilitate appropriate reimbursement accurately.

D47.3: Essential thrombocythemia - Yes. Essential thrombocythemia with splenomegaly is billable as it signifies a specific hematological disorder that requires monitoring and treatment.

D73.1: Felty's syndrome - Yes. Felty's syndrome with splenomegaly is a billable code as it represents a distinct clinical entity requiring attention and management.

C88.8: Other specified malignant neoplasms of lymphoid, hematopoietic, and related tissues - No. This code pertains to malignant neoplasms and is not specifically related to splenomegaly unless it is the primary reason for the encounter.

D73.81: Macrophage activation syndrome - Yes. Macrophage activation syndrome with splenomegaly is a billable code as it is a severe condition requiring specific care and attention.

K70.30: Alcoholic cirrhosis of liver without ascites - No. While alcoholic cirrhosis may be associated with splenomegaly, this specific code does not focus on splenomegaly as the primary condition being addressed.

Clinical Information

• Splenomegaly refers to the abnormal enlargement of the spleen, a vital organ located in the upper left abdomen.
• Various underlying medical conditions or factors, including infections, liver diseases, blood disorders, autoimmune diseases, and certain cancers can cause it.
• The clinical presentation of splenomegaly may vary depending on the underlying cause and the severity of enlargement.
• Common symptoms include abdominal pain or discomfort, a feeling of fullness or early satiety, fatigue, easy bruising or bleeding, and frequent infections.
• Physical examination may reveal a palpable, enlarged spleen during abdominal examination.
• Diagnostic tests such as ultrasound, CT scan, or MRI can confirm the presence and measure the extent of splenomegaly.
• Treatment of splenomegaly focuses on addressing the underlying cause, managing symptoms, and preventing complications.
• In some cases, surgical spleen removal (splenectomy) may be necessary.
• Splenomegaly requires ongoing monitoring and management to ensure appropriate treatment and prevent complications such as splenic rupture, anemia, or immune system dysfunction.
• The ICD-10 codes mentioned earlier help accurately document and code splenomegaly cases, facilitating proper diagnosis, treatment, and research in various medical conditions associated with an enlarged spleen.

Synonyms Include:

• Enlarged spleen
• Splenic enlargement
• Splenomegaly
• Megalosplenia
• Hypersplenia