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D78.11 ICD-10-CM Code: Accidental puncture and laceration of the spleen during a procedure on the spleen

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Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Billable · FY2027A valid, specific ICD-10-CM code, reportable for dates of service in FY2027.

What you need to know

Source: CMS/NCHS Official ICD-10-CM tabular notes, quoted. From the CMS/NCHS tabular list for the release in force. A note the category or block publishes applies to this code too; the Instructions section marks which is which.

The tabular list publishes no instructional note for this code itself.

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Inpatient Payment Groups (MS-DRG)

Potential MS-DRG participation — not a DRG assignment.

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v44, Appendix B.

  • MS-DRG 791 — PREMATURITY WITH MAJOR PROBLEMS (MDC 15)
  • MS-DRG 793 — FULL TERM NEONATE WITH MAJOR PROBLEMS (MDC 15)
  • MS-DRG 919 — COMPLICATIONS OF TREATMENT WITH MCC (MDC 21)
  • MS-DRG 920 — COMPLICATIONS OF TREATMENT WITH CC (MDC 21)
  • MS-DRG 921 — COMPLICATIONS OF TREATMENT WITHOUT CC/MCC (MDC 21)

A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.

Coding context

Guidelines, coding notes, decision aids, relationships (with MS-DRG and CCSR classification), hierarchy, HCC, coverage and the context map: what a coder reaches for after the core. Each section names whether it is official source data, a MedCoder-derived relationship or MedCoder editorial.

Code Overview

Accidental puncture and laceration of the spleen during a procedure on the spleen is a billable ICD-10-CM diagnosis code (D78.11).

MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.

Official Coding Guidelines

No excerpt in the ICD-10-CM Official Guidelines names this code specifically. Its chapter carries only this chapter-wide note:

Chapter 3: Disease of the blood and blood-forming organs and certain disorders involving the immune mechanism (D50-D89)

Reserved for future guideline expansion

Verify Before Coding

  • CC as a secondary diagnosis (FY2027). Can raise the stay's MS-DRG severity tier.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.

Relationships & Classification

MedCoder-derived relationships — computed from published CMS and AHRQ datasets

Other codes that name D78.11 or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.

Referenced by 1 Excludes1 note: D78.0 — Intraoperative hemorrhage and hematoma of the spleen complicating a procedure (via D78.1.-).

These codes’ tabular lists mark this diagnosis as mutually exclusive — not reported together unless the conditions are documented as unrelated.

Referenced by 10 Excludes2 notes: T80 — Complications following infusion, transfusion and therapeutic injection (via D78.-), T80-T88 — Complications of surgical and medical care, not elsewhere classified (T80-T88) (via D78.-), T81 — Complications of procedures, not elsewhere classified (via D78.-), T82 — Complications of cardiac and vascular prosthetic devices, implants and grafts (via D78.-), T83 — Complications of genitourinary prosthetic devices, implants and grafts (via D78.-), T84 — Complications of internal orthopedic prosthetic devices, implants and grafts (via D78.-), T85 — Complications of other internal prosthetic devices, implants and grafts (via D78.-), T86 — Complications of transplanted organs and tissue (via D78.-), T87 — Complications peculiar to reattachment and amputation (via D78.-), T88 — Other complications of surgical and medical care, not elsewhere classified (via D78.-).

These codes’ tabular lists name this diagnosis as distinct — both may be reported when both are documented.

MS-DRG Grouper Relationships (FY2027)

Potential MS-DRG participation — not a DRG assignment.

FY2027 MS-DRG: CC — Complication or Comorbidity. Reported as a secondary diagnosis, this code raises the stay's MS-DRG severity tier — except when the principal diagnosis is one of 78 clinically related codes on its CMS exclusion list.

Named in the grouper logic of 5 MS-DRGs: DRG 791 (MDC 15), DRG 793 (MDC 15), DRG 919 (MDC 21), DRG 920 (MDC 21), DRG 921 (MDC 21).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Clinical classification (AHRQ CCSR):BLD009 — Postprocedural or postoperative complications of the spleen (default).

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Related Codes

Same clinical process (MS-DRG)

Acts as CC — raises the severity of other admissions. CMS groups these diagnoses into one MS-DRG principal-diagnosis exclusion process — a CC/MCC on this list never raises severity when the principal diagnosis is also on it.

D78.12 — Accidental puncture and laceration of the spleen during other procedure, D78.81 — Other intraoperative complications of the spleen, D78.89 — Other postprocedural complications of the spleen, E36.11 — Accidental puncture and laceration of an endocrine system organ or structure during an endocrine system procedure, E36.12 — Accidental puncture and laceration of an endocrine system organ or structure during other procedure, E36.8 — Other intraoperative complications of endocrine system, E89.810 — Postprocedural hemorrhage of an endocrine system organ or structure following an endocrine system procedure, E89.811 — Postprocedural hemorrhage of an endocrine system organ or structure following other procedure, E89.820 — Postprocedural hematoma of an endocrine system organ or structure following an endocrine system procedure, E89.821 — Postprocedural hematoma of an endocrine system organ or structure following other procedure, E89.822 — Postprocedural seroma of an endocrine system organ or structure following an endocrine system procedure, E89.823 — Postprocedural seroma of an endocrine system organ or structure following other procedure, E89.830 — Post bariatric hypoglycemia, E89.838 — Other postprocedural hypoglycemia, E89.89 — Other postprocedural endocrine and metabolic complications and disorders, G96.11 — Dural tear, G97.41 — Accidental puncture or laceration of dura during a procedure, G97.48 — Accidental puncture and laceration of other nervous system organ or structure during a nervous system procedure, G97.49 — Accidental puncture and laceration of other nervous system organ or structure during other procedure, H59.011 — Keratopathy (bullous aphakic) following cataract surgery, right eye, +57 more

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Postprocedural or postoperative complications of the spleen).

D78.01 — Intraoperative hemorrhage and hematoma of the spleen complicating a procedure on the spleen, D78.02 — Intraoperative hemorrhage and hematoma of the spleen complicating other procedure, D78.12 — Accidental puncture and laceration of the spleen during other procedure, D78.21 — Postprocedural hemorrhage of the spleen following a procedure on the spleen, D78.22 — Postprocedural hemorrhage of the spleen following other procedure, D78.31 — Postprocedural hematoma of the spleen following a procedure on the spleen, D78.32 — Postprocedural hematoma of the spleen following other procedure, D78.33 — Postprocedural seroma of the spleen following a procedure on the spleen, D78.34 — Postprocedural seroma of the spleen following other procedure, D78.81 — Other intraoperative complications of the spleen, D78.89 — Other postprocedural complications of the spleen

Contextual Map

Every relationship of D78.11 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Run D78.11 with these 9 related codes in Claim Check

Hierarchy

Referenced by Excludes1 notes

Referenced by Excludes2 notes (10)

Clinical classification (CCSR)

MS-DRG Grouper

MDC crossing

  • MDC 15 — Newborns and Other Neonates with Conditions Originating in Perinatal Period[MDC crossing]: “Newborns and Other Neonates with Conditions Originating in Perinatal Period — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs.”— CMS MS-DRG Definitions Manual · FY2027
  • MDC 21 — Injuries, Poisonings and Toxic Effects of Drugs[MDC crossing]: “Injuries, Poisonings and Toxic Effects of Drugs — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs. 32,063 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2027

Index entries

  • Complication (s) (from) (of), intraoperative (intraprocedural), puncture or laceration (accidental) (unintentional) (of), spleen, during a procedure on the spleen[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027

Nearest codes (17)

Change history

  • FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016

Reference

Index terms and tables, published questions and FAQ, every source behind this page with its release and checksum, the date-of-service check and the complete change history.

Indexed Clinical Terms (1)

Official source data — entries quoted as published, in the Index’s own lookup phrasing

Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code. These are alphabetic-index entries shown as the Index writes them — lookup phrasing, not necessarily the wording of a final diagnosis.

Sources for this page

Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.

Code, title, tabular notes and index terms Official source data
CMS/CDC ICD-10-CM FY2027 tabular list, index and tables, effective October 1, 2026 Release, file and checksum · Publisher’s page
Coding guidelines Official source data
ICD-10-CM Official Guidelines for Coding and Reporting (FY2027), quoted by section Release, file and checksum · Publisher’s page
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v44.0 (October 2026) Release, file and checksum · Publisher’s page
Inpatient payment groups Official source data
CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v44 Release, file and checksum · Publisher’s page
Change history and date-of-service validity Official source data
CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page
Comparisons, relationships and the contextual map MedCoder-derived relationship
Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
Summary and FAQ answers MedCoder editorial explanation
Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.

Current data releases:ICD-10-CM FY2027 · ICD-10-PCS FY2027 · HCPCS October 2026 · MS-DRG v44 · Medicare Code Editor v44.0 · NCCI PTP Q4 2026 · MUE Q4 2026 · NCD code lists 2026-01 · LCD export September 28, 2026 · All releases and sources

Labels on this page: Official source data · MedCoder-derived relationship · MedCoder editorial explanation. How to read the labels · All data sources and release dates · CMS coding rules

Cite this page

Reference this page in a research guide, syllabus or article. The release is included because code content changes each year.

MedCoder.ai. "D78.11 — Accidental puncture and laceration of the spleen during a procedure on the spleen." ICD-10-CM FY2027. https://medcoder.ai/icd10/code/d78.11-accidental-puncture-and-laceration-of-the-spleen-during-a-procedure-on-the-spleen

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Accidental puncture and laceration of the spleen during a procedure on the spleen

No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027, and none are recorded for this code. Note changes are tracked from FY2027 only.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to D78.11 in its code family, with their registry titles.

View all codes in the D78 family