P54.0 vs R16
P54.0 (Neonatal hematemesis) compared with R16 (Hepatomegaly and splenomegaly, not elsewhere classified), from the official CMS tabular data. Both may be reported when both conditions are documented (Excludes2).
Can these codes be reported together?
Yes, when both are documented. R16 carries an Excludes2 note covering P54.0: “newborn gastrointestinal hemorrhage (P54.0-P54.3)”
Excludes2 marks distinct conditions — both may be reported when both are documented.
Side by side
| P54.0Neonatal hematemesis | R16Hepatomegaly and splenomegaly, not elsewhere classified | |
|---|---|---|
| Billing status | Billable | Non-billable header |
| Classification | P00-P96 — Certain Conditions Originating in the Perinatal Period (P00-P96) | R00-R99 — Symptoms, Signs and Abnormal Clinical and Laboratory Findings, Not Elsewhere Classified (R00-R99) |
| Definition | Neonatal hematemesis is a billable ICD-10-CM diagnosis code (P54.0). | Hepatomegaly and splenomegaly, not elsewhere classified is a non-billable ICD-10-CM category code (R16). |
Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources