ICD-10 P15.1
Billable / SpecificBirth injury to spleen
About ICD-10-CM P15.1
ICD-10-CM code P15.1 represents Birth injury to spleen. This is a billable/specific code in the Perinatal Period chapter (block P15). The 2026 edition of ICD-10-CM P15.1 became effective on October 1, 2025.
Inclusion Terms / Approximate Synonyms
Clinical terms and conditions classified under P15.1. Per CMS ICD-10-CM Tabular 2026.
- Rupture of spleen due to birth injury
Medicare LCD Coverage for P15.1
Local Coverage Determinations (LCDs) from CMS MACs that list P15.1 as a covered diagnosis.
This doesn't mean the code isn't covered, it means no MAC has issued a Local Coverage Determination naming this specific code. Coverage may still apply under National Coverage Determinations or general medical-necessity rules.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing P15.1.
Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but P15.1 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.
CPT Codes Commonly Billed with P15.1
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.
Convert P15.1 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 |
|---|---|---|
| P15.1 | 7678 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To P15.1
Other codes in section P10-P15 (Birth trauma).
ICD-10 P15.1, Billing FAQ
Is ICD-10 code P15.1 billable? +
Yes, P15.1 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
What other names or terms map to P15.1? +
ICD-10 P15.1 includes: Rupture of spleen due to birth injury.
What ICD-9 codes does P15.1 map to? +
Per CMS GEMs, P15.1 maps to ICD-9 codes: 7678. 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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