ICD-10-CM Code For Hepatomegaly And Splenomegaly Not Elsewhere Classified: Group Overview

The International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) code group R16 includes diagnoses of hepatomegaly and splenomegaly that are not classified elsewhere, covering clinical findings of liver or spleen enlargement regardless of specific etiology. These ICD-10-CM diagnosis codes are used to document clinical presentations where organ enlargement is observed, capturing extent of organ involvement and related clinical complexity. Accurate coding within the ICD-10-CM R16 group supports proper claim adjudication, complete clinical documentation, and appropriate reimbursement.

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ICD-10-CM R16: Hepatomegaly And Splenomegaly, Not Elsewhere Classified Overview

The ICD-10-CM R16 group represents diagnoses of enlargement of the liver (hepatomegaly) and enlargement of the spleen (splenomegaly) when not classified elsewhere. These signs involve the digestive and abdominal organ systems and may reflect a range of underlying disorders. Accurate coding ensures clinical records reflect organ involvement and supports proper claim adjudication and reimbursement.

When to Use

Use a code from this group when a clinician documents enlargement of the liver or spleen and no more specific diagnosis code for the underlying cause is available. These codes apply to clinical encounters where the organ enlargement is a primary documented finding requiring capture in the medical record and billing.

ICD-10-CM Codes

3 rows

ICD-10-CM Code	Description
R16.0	Hepatomegaly, not elsewhere classified
R16.1	Splenomegaly, not elsewhere classified
R16.2	Hepatomegaly with splenomegaly, not elsewhere classified

DRG Codes

6 rows

DRG Code	Description
441	Disorders of Liver Except Malignancy, Cirrhosis or Alcoholic Hepatitis with MCC
442	Disorders of Liver Except Malignancy, Cirrhosis or Alcoholic Hepatitis with CC
443	Disorders of Liver Except Malignancy, Cirrhosis or Alcoholic Hepatitis without CC/MCC
814	Reticuloendothelial and Immunity Disorders with MCC
815	Reticuloendothelial and Immunity Disorders with CC
816	Reticuloendothelial and Immunity Disorders without CC/MCC

Typical Clinical Scenarios

An adult patient presents to the emergency department with acute onset abdominal pain, visible abdominal fullness, and jaundice after several days of fever and anorexia. On exam there is tender hepatomegaly without focal masses; bedside ultrasound confirms an enlarged liver consistent with acute hepatic inflammation. A symptom code from the group is used when the clinician documents hepatomegaly as a presenting finding rather than a confirmed specific liver disease. Typical codes: R16.0
A middle-aged patient in outpatient hepatology clinic with known nonalcoholic fatty liver disease reports progressive abdominal distension and early satiety over months; physical exam and imaging show chronic enlargement of the liver and spleen without evidence of portal hypertension complications. The provider documents chronic hepatosplenomegaly as an ongoing clinical sign to monitor disease progression and staging. Typical codes: R16.2
A hospitalized patient with a hematologic malignancy develops new left upper quadrant fullness and cytopenias; exam and ultrasound demonstrate isolated splenomegaly attributed to disease infiltration and hypersplenism rather than trauma or infection. The splenic enlargement is recorded as a clinical finding that impacts management and transfusion planning. Typical codes: R16.1

Related Codes

R10-ABDOMINAL-AND-PELVIC-PAIN

ICD-10-CM Code For Abdominal And Pelvic Pain: Group Overview

R11-NAUSEA-AND-VOMITING

ICD-10-CM Code For Nausea And Vomiting: Group Overview

R12-HEARTBURN

ICD-10-CM Code For Heartburn: Group Overview

R13-APHAGIA-AND-DYSPHAGIA

ICD-10-CM Code For Aphagia And Dysphagia: Group Overview

R14-FLATULENCE-AND-RELATED-CONDITIONS

ICD-10-CM Code For Flatulence And Related Conditions: Group Overview

R15-FECAL-INCONTINENCE

ICD-10-CM Code For Fecal Incontinence: Group Overview

R17-UNSPECIFIED-JAUNDICE

ICD-10-CM Code For Unspecified Jaundice: Group Overview

R18-ASCITES

ICD-10-CM Code For Ascites: Group Overview

R19-OTHER-SYMPTOMS-AND-SIGNS-DIGESTIVE-SYSTEM

ICD-10-CM Code For Other Symptoms And Signs Involving The Digestive System And Abdomen: Group Overview

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

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When to Use

ICD-10-CM Codes

3 rows

ICD-10-CM Code	Description
R16.0	Hepatomegaly, not elsewhere classified
R16.1	Splenomegaly, not elsewhere classified
R16.2	Hepatomegaly with splenomegaly, not elsewhere classified

DRG Codes

6 rows

DRG Code	Description
441	Disorders of Liver Except Malignancy, Cirrhosis or Alcoholic Hepatitis with MCC
442	Disorders of Liver Except Malignancy, Cirrhosis or Alcoholic Hepatitis with CC
443	Disorders of Liver Except Malignancy, Cirrhosis or Alcoholic Hepatitis without CC/MCC
814	Reticuloendothelial and Immunity Disorders with MCC
815	Reticuloendothelial and Immunity Disorders with CC
816	Reticuloendothelial and Immunity Disorders without CC/MCC

Typical Clinical Scenarios

An adult patient presents to the emergency department with acute onset abdominal pain, visible abdominal fullness, and jaundice after several days of fever and anorexia. On exam there is tender hepatomegaly without focal masses; bedside ultrasound confirms an enlarged liver consistent with acute hepatic inflammation. A symptom code from the group is used when the clinician documents hepatomegaly as a presenting finding rather than a confirmed specific liver disease. Typical codes: R16.0
A middle-aged patient in outpatient hepatology clinic with known nonalcoholic fatty liver disease reports progressive abdominal distension and early satiety over months; physical exam and imaging show chronic enlargement of the liver and spleen without evidence of portal hypertension complications. The provider documents chronic hepatosplenomegaly as an ongoing clinical sign to monitor disease progression and staging. Typical codes: R16.2
A hospitalized patient with a hematologic malignancy develops new left upper quadrant fullness and cytopenias; exam and ultrasound demonstrate isolated splenomegaly attributed to disease infiltration and hypersplenism rather than trauma or infection. The splenic enlargement is recorded as a clinical finding that impacts management and transfusion planning. Typical codes: R16.1

Related Codes

R10-ABDOMINAL-AND-PELVIC-PAIN

ICD-10-CM Code For Abdominal And Pelvic Pain: Group Overview

R11-NAUSEA-AND-VOMITING

ICD-10-CM Code For Nausea And Vomiting: Group Overview

R12-HEARTBURN

ICD-10-CM Code For Heartburn: Group Overview

R13-APHAGIA-AND-DYSPHAGIA

ICD-10-CM Code For Aphagia And Dysphagia: Group Overview

R14-FLATULENCE-AND-RELATED-CONDITIONS

ICD-10-CM Code For Flatulence And Related Conditions: Group Overview

R15-FECAL-INCONTINENCE

ICD-10-CM Code For Fecal Incontinence: Group Overview

R17-UNSPECIFIED-JAUNDICE

ICD-10-CM Code For Unspecified Jaundice: Group Overview

R18-ASCITES

ICD-10-CM Code For Ascites: Group Overview

R19-OTHER-SYMPTOMS-AND-SIGNS-DIGESTIVE-SYSTEM

ICD-10-CM Code For Other Symptoms And Signs Involving The Digestive System And Abdomen: Group Overview

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

ICD-10-CM Code For Hepatomegaly And Splenomegaly Not Elsewhere Classified: Group Overview

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ICD-10-CM R16: Hepatomegaly And Splenomegaly, Not Elsewhere Classified Overview

ICD-10-CM Code For Hepatomegaly And Splenomegaly Not Elsewhere Classified: Group Overview

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ICD-10-CM R16: Hepatomegaly And Splenomegaly, Not Elsewhere Classified Overview

When to Use

ICD-10-CM Codes

DRG Codes

Typical Clinical Scenarios

Related Codes

Which ICD-10-CM codes are included in the R16 group?

What clinical findings does ICD-10-CM R16 represent?

How does accurate coding within the R16 group support claims and documentation?

Which DRGs are related to the R16 group?

When should a coder use an R16 code instead of a disease-specific code?

References

When to Use

ICD-10-CM Codes

DRG Codes

Typical Clinical Scenarios

Related Codes

Which ICD-10-CM codes are included in the R16 group?

What clinical findings does ICD-10-CM R16 represent?

How does accurate coding within the R16 group support claims and documentation?

Which DRGs are related to the R16 group?

When should a coder use an R16 code instead of a disease-specific code?

References