Is D78.1 a billable ICD-10-CM code?

No. D78.1 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does D78.1 sit in the tabular list?

Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism (D50-D89), in the block Intraoperative and postprocedural complications of the spleen (D78).

D78.1

D78.1 — Accidental puncture and laceration of the spleen during a procedure

Non-billable headerICD-10-CM

D78.1 is a non-billable header ICD-10-CM code for accidental puncture and laceration of the spleen during a procedure. It cannot be billed on its own: choose one of the more specific child codes below.

Other codes that can never be billed with D78.1

These codes carry an Excludes1 note pointing at D78.1. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading D78.1 alone.

D78.0Intraoperative hemorrhage and hematoma of the spleen complicating a procedure

Risk adjustment

D78.1 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.

Code to one of these instead D78.1

2 child codes. Green means billable.

Related codes at this level

Codes that share D78. If D78.1 is not quite right, the correct code is usually one of these.

Questions about D78.1

Is D78.1 a billable ICD-10-CM code?: No. D78.1 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does D78.1 sit in the tabular list?: Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism (D50-D89), in the block Intraoperative and postprocedural complications of the spleen (D78).