ICD-10 D78.31
Billable / Specific CCPostprocedural hematoma of the spleen following a procedure on the spleen
About ICD-10-CM D78.31
ICD-10-CM code D78.31 represents Postprocedural hematoma of the spleen following a procedure on the spleen. This is a billable/specific code in the Blood and Blood-forming Organs chapter (block D78). The 2026 edition of ICD-10-CM D78.31 became effective on October 1, 2025.
Coding Tips for D78.31
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
D78.31 is designated CC for MS-DRG grouping. On inpatient claims, this code can shift the DRG to the with-CC variant when documented as a present-on-admission secondary diagnosis. Hospital CDI programs flag CC opportunities during chart review. Failure to capture this code may leave 30 to 80 percent of the inpatient stay revenue unrealized.
Inpatient DRG Impact, CC
codes Postprocedural hematoma of the spleen following a procedure on the spleen. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.
Medicare LCD Coverage for D78.31
Local Coverage Determinations (LCDs) from CMS MACs that list D78.31 as a covered diagnosis.
Showing top 10 of 24 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing D78.31.
1 Medicare
CPT Codes Commonly Billed with D78.31
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
- C8931 CMS LCD: Billing and Coding: Magnetic Resonance Angiography CMS LCD
- C8936 CMS LCD: Billing and Coding: Magnetic Resonance Angiography CMS LCD
- C8934 CMS LCD: Billing and Coding: Magnetic Resonance Angiography CMS LCD
- C8932 CMS LCD: Billing and Coding: Magnetic Resonance Angiography CMS LCD
- C8935 CMS LCD: Billing and Coding: Magnetic Resonance Angiography CMS LCD
- C8933 CMS LCD: Billing and Coding: Magnetic Resonance Angiography CMS LCD
Convert D78.31 to ICD-9-CM
Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.
| ICD-10 | ICD-9 | Mapping Flags |
|---|---|---|
| D78.31 | 99812 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To D78.31
Other codes in section D78 (Intraoperative and postprocedural complications of the spleen).
ICD-10 D78.31, Billing FAQ
Is ICD-10 code D78.31 billable? +
Yes, D78.31 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
Is D78.31 a CC or MCC for inpatient DRG? +
Yes, this code is designated as CC. Documenting as a secondary diagnosis on inpatient claims can shift the DRG to a higher-weighted category.
What CPT codes are commonly billed with D78.31? +
Procedures frequently paired with D78.31 include: C8931, C8936, C8934, C8932, C8935.
What ICD-9 codes does D78.31 map to? +
Per CMS GEMs, D78.31 maps to ICD-9 codes: 99812. Useful for legacy data review and historical claim analysis.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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