D73.1 vs R16.1
D73.1 (Hypersplenism) compared with R16.1 (Splenomegaly, not elsewhere classified), from the official CMS tabular data. Do not report these codes together: the official tabular list marks them Excludes1.
Can these codes be reported together?
No — do not report together. D73.1 carries an Excludes1 note covering R16.1: “splenomegaly NOS (R16.1)”
Sole exception: when the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).
Side by side
| D73.1Hypersplenism | R16.1Splenomegaly, not elsewhere classified | |
|---|---|---|
| Billing status | Billable | Billable |
| Classification | D50-D89 — Diseases of the Blood and Blood-forming Organs and Certain Disorders Involving the Immune Mechanism (D50-D89) | R00-R99 — Symptoms, Signs and Abnormal Clinical and Laboratory Findings, Not Elsewhere Classified (R00-R99) |
| Definition | Hypersplenism is a billable ICD-10-CM diagnosis code (D73.1). | Splenomegaly, not elsewhere classified is a billable ICD-10-CM diagnosis code (R16.1). |
| Includes | — | Splenomegaly NOS |
Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources