D73.1

D73.1: Hypersplenism

Billable / specific codeICD-10-CM

D73.1 is a billable, specific ICD-10-CM code for hypersplenism. It is valid for submission on a claim.

Check D73.1 with the rest of the claim: free scrubber

Excludes1: never code together

These conditions cannot occur together. Billing both on the same encounter is a denial.

neutropenic splenomegaly (D73.81)
primary splenic neutropenia (D73.81)
splenitis, splenomegaly in late syphilis (A52.79)
splenitis, splenomegaly in tuberculosis (A18.85)
splenomegaly NOS (R16.1)
splenomegaly congenital (Q89.0)

Risk adjustment

No CMS-HCC V28 category: this code does not change a RAF score.

Medicare coverage

D73.1 is named in 5 Medicare coverage policies: 5 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

A55717Billing and Coding: Lab: Flow Cytometry
A56421Billing and Coding: CT of the Abdomen and Pelvis
A56464Billing and Coding: Flow Cytometry
A57189Billing and Coding: Serum Magnesium

Alphabetic index entries that lead here

Big spleen syndrome
Gamna's disease(siderotic splenomegaly)
Gandy-Nanta disease(siderotic splenomegaly)
Hypersplenia, hypersplenism
Aleukia›splenica
Increase, increased›splenic activity
Metaplasia›myelogenous
Metaplasia›myeloid(agnogenic) (megakaryocytic)
Metaplasia›spleen
Panhematopenia›splenic, primary
Syndrome›big spleen
Syndrome›hypersplenic

Code history

Unchanged in every release from FY2024 to FY2027.