ICD-10-CM 2027
ICD-10 code for splenomegaly
From the official ICD-10-CM alphabetic index entry “Splenomegaly, splenomegalia (Bengal) (cryptogenic) (idiopathic) (tropical)”. Page updated September 29, 2026.
About coding splenomegaly
The ICD-10-CM code for splenomegaly is R16.1 (Splenomegaly, not elsewhere classified). The official index lists 11 more specific codes, so check the documentation for details such as type, cause, site or severity before settling on R16.1.
Within R16 (Hepatomegaly and splenomegaly, not elsewhere classified), R16.1 is specifically for splenomegaly, not elsewhere classified. Related codes cover Hepatomegaly, not elsewhere classified (R16.0) and Hepatomegaly with splenomegaly, not elsewhere classified (R16.2).
It is not a CC or MCC, so as a secondary diagnosis it doesn't change the MS-DRG severity level.
In MS-DRG v44.0, it is part of the grouping logic for DRG 814 (Reticuloendothelial and Immunity Disorders with MCC, relative weight 2.0729), DRG 815 (Reticuloendothelial and Immunity Disorders with CC, relative weight 1.0444) and DRG 816 (Reticuloendothelial and Immunity Disorders without CC/MCC, relative weight 0.7381), in MDC 16 (Diseases and Disorders of the Blood and Blood Forming Organs and Immunological Disorders), as a principal or secondary diagnosis. The DRG a claim lands in depends on the principal diagnosis, procedures and any CC/MCC secondary diagnoses.
More specific splenomegaly codes (official index)
- with hepatomegaly R16.2 — Hepatomegaly with splenomegaly, not elsewhere classified
- cirrhotic D73.2 — Chronic congestive splenomegaly
- congenital Q89.09 — Congenital malformations of spleen
- congestive, chronic D73.2 — Chronic congestive splenomegaly
- Egyptian B65.1 — Schistosomiasis due to Schistosoma mansoni [intestinal schistosomiasis]
- Gaucher's E75.22 — Gaucher disease
- malarial B54 — Unspecified malaria
- neutropenic D73.81 — Neutropenic splenomegaly
- Niemann-Pick
- siderotic D73.2 — Chronic congestive splenomegaly
- syphilitic A52.79 — Other symptomatic late syphilis
- congenital (early) A50.08 — Early visceral congenital syphilis
Common questions about splenomegaly ICD-10 codes
What is the ICD-10 code for splenomegaly?
- R16.1 — Splenomegaly, not elsewhere classified. More specific codes apply when the documentation supports them: R16.2, D73.2, Q89.09, D73.2 and others below.
What is the ICD-10 code for cirrhotic splenomegaly?
- D73.2 — Chronic congestive splenomegaly.
What is the ICD-10 code for congenital splenomegaly?
- Q89.09 — Congenital malformations of spleen.
What is the ICD-10 code for egyptian splenomegaly?
- B65.1 — Schistosomiasis due to Schistosoma mansoni [intestinal schistosomiasis].
What is the ICD-10 code for gaucher's splenomegaly?
- E75.22 — Gaucher disease.
What is the ICD-10 code for malarial splenomegaly?
- B54 — Unspecified malaria.
What is the ICD-10 code for neutropenic splenomegaly?
- D73.81 — Neutropenic splenomegaly.
Is R16.1 billable?
- Yes. R16.1 is a billable/specific ICD-10-CM code valid for FY2027 (October 1, 2026 – September 30, 2027).
Can R16.1 be used as a principal diagnosis?
- Yes. The Medicare Code Editor doesn't restrict R16.1 as a principal diagnosis.
Is R16.1 a CC or MCC?
- No. R16.1 is neither a CC nor an MCC under MS-DRG v44.0.