ICD-10 R16.1
Billable / SpecificSplenomegaly, not elsewhere classified
About ICD-10-CM R16.1
ICD-10-CM code R16.1 represents Splenomegaly, not elsewhere classified. This is a billable/specific code in the Symptoms, Signs, and Abnormal Findings chapter (block R16). The 2026 edition of ICD-10-CM R16.1 became effective on October 1, 2025.
Inclusion Terms / Approximate Synonyms
Clinical terms and conditions classified under R16.1. Per CMS ICD-10-CM Tabular 2026.
- Splenomegaly NOS
Medicare LCD Coverage for R16.1
Local Coverage Determinations (LCDs) from CMS MACs that list R16.1 as a covered diagnosis.
Showing top 10 of 643 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing R16.1.
5 Medicare
CPT Codes Commonly Billed with R16.1
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
- 74177 CT abdomen/pelvis with contrast — abdominal pain, colon cancer staging, liver mets, cholelithiasis, pancreatitis, chronic pancreatitis, pancreatic cancer, hepatomegaly, splenomegaly, abnormal imaging Radiology
Convert R16.1 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 |
|---|---|---|
| R16.1 | 7892 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To R16.1
Other codes in section R10-R19 (Symptoms and signs involving the digestive system and abdomen).
ICD-10 R16.1, Billing FAQ
Is ICD-10 code R16.1 billable? +
Yes, R16.1 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 R16.1? +
ICD-10 R16.1 includes: Splenomegaly NOS.
What CPT codes are commonly billed with R16.1? +
Procedures frequently paired with R16.1 include: 74177.
What ICD-9 codes does R16.1 map to? +
Per CMS GEMs, R16.1 maps to ICD-9 codes: 7892. 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 July 16, 2026.
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