D78.12 — Accidental puncture and laceration of the spleen during other procedure
D78.12 is a billable, specific ICD-10-CM code for accidental puncture and laceration of the spleen during other procedure. It is valid for submission on a claim.
Risk adjustment
D78.12 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.
Medicare coverage
D78.12 is named in 1 Medicare coverage policy — 1 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A56421Billing and Coding: CT of the Abdomen and Pelvis
How D78.12 is indexed
Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to D78.12.
- Complication›intraoperative›puncture or laceration›spleen›during a procedure on other organ
Related codes at this level
Codes that share D78.1. If D78.12 is not quite right, the correct code is usually one of these.
Questions about D78.12
- Is D78.12 a billable ICD-10-CM code?
- Yes. D78.12 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does D78.12 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).