R16.1

Splenomegaly, not elsewhere classified

Billable / specific

R16.1 is a billable, specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes in FY2027.

Inclusion terms

Applicable to

  • Splenomegaly NOS

Includes (from R16)

  • Note: 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.
  • Note: 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.
  • Note: The conditions and signs or symptoms included in categories R00-R94 consist of:
  • Note: (a) cases for which no more specific diagnosis can be made even after all the facts bearing on the case have been investigated;
  • Note: (b) signs or symptoms existing at the time of initial encounter that proved to be transient and whose causes could not be determined;
  • Note: (c) provisional diagnosis in a patient who failed to return for further investigation or care;
  • Note: (d) cases referred elsewhere for investigation or treatment before the diagnosis was made;
  • Note: (e) cases in which a more precise diagnosis was not available for any other reason;
  • Note: (f) certain symptoms, for which supplementary information is provided, that represent important problems in medical care in their own right.

Excludes2

Not included here — may be reported together when both conditions exist.

  • abnormal findings on antenatal screening of mother (O28.-) (from R16)
  • certain conditions originating in the perinatal period (P04-P96) (from R16)
  • signs and symptoms classified in the body system chapters (from R16)
  • signs and symptoms of breast (N63, N64.5) (from R16)
  • congenital or infantile pylorospasm (Q40.0) (from R16)
  • gastrointestinal hemorrhage (K92.0-K92.2) (from R16)
  • intestinal obstruction (K56.-) (from R16)
  • newborn gastrointestinal hemorrhage (P54.0-P54.3) (from R16)
  • newborn intestinal obstruction (P76.-) (from R16)
  • pylorospasm (K31.3) (from R16)
  • signs and symptoms involving the urinary system (R30-R39) (from R16)
  • symptoms referable to female genital organs (N94.-) (from R16)
  • symptoms referable to male genital organs (N48-N50) (from R16)

Also known as

  • Splenomegaly NOS
  • Débove's disease
  • Disease, diseased, Débove's
  • Mass, splenic
  • Splenomegaly, splenomegalia

Parent code

  • R16Hepatomegaly and splenomegaly, not elsewhere classifiedHeader

Related codes

  • R16.0Hepatomegaly, not elsewhere classifiedBillable
  • R16.2Hepatomegaly with splenomegaly, not elsewhere classifiedBillable

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