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ICD-10 Guide
ICD-10 CodesD73.81

D73.81

Billable

Neutropenic splenomegaly

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/05/2025

Code Description

ICD-10 D73.81 is a billable code used to indicate a diagnosis of neutropenic splenomegaly.

Key Diagnostic Point:

Neutropenic splenomegaly is a condition characterized by the enlargement of the spleen (splenomegaly) in patients who have neutropenia, which is a lower-than-normal number of neutrophils, a type of white blood cell essential for fighting infections. This condition can arise from various underlying causes, including bone marrow disorders, autoimmune diseases, infections, and certain medications that suppress bone marrow function. The spleen plays a crucial role in filtering blood and managing immune responses, and its enlargement can lead to complications such as hypersplenism, where the spleen overactively removes blood cells, further exacerbating neutropenia. Clinically, patients may present with symptoms such as fatigue, recurrent infections, and abdominal discomfort due to splenic enlargement. Diagnosis typically involves blood tests to assess white blood cell counts, imaging studies to evaluate spleen size, and possibly bone marrow biopsies to determine the underlying cause of neutropenia. Management focuses on treating the underlying condition, monitoring blood counts, and addressing any complications arising from splenomegaly.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Requires understanding of both hematological and splenic disorders.
  • Differentiation from other types of splenomegaly.
  • Need for comprehensive documentation of underlying causes.
  • Potential for multiple co-existing conditions affecting coding.

Audit Risk Factors

  • Inadequate documentation of neutropenia severity.
  • Failure to document the underlying cause of neutropenia.
  • Misclassification of splenomegaly type.
  • Inconsistent coding of related conditions.

Specialty Focus

Medical Specialties

Hematology

Documentation Requirements

Detailed blood work results, including neutrophil counts and bone marrow findings.

Common Clinical Scenarios

Patients with chronic neutropenia due to bone marrow disorders or autoimmune conditions.

Billing Considerations

Ensure clear documentation of the relationship between neutropenia and splenomegaly.

Internal Medicine

Documentation Requirements

Comprehensive patient history and physical examination findings related to splenomegaly.

Common Clinical Scenarios

Patients presenting with recurrent infections and splenomegaly.

Billing Considerations

Document any associated symptoms and the impact on the patient's overall health.

Coding Guidelines

Inclusion Criteria

Use D73.81 When
  • According to ICD
  • 10 coding guidelines, D73
  • 81 should be used when neutropenic splenomegaly is specifically documented
  • Coders must ensure that the underlying cause of neutropenia is also documented, as this may affect treatment and management

Exclusion Criteria

Do NOT use D73.81 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

85025CPT Code

Complete blood count (CBC) with differential

Clinical Scenario

Used to evaluate neutrophil levels in patients with suspected neutropenia.

Documentation Requirements

Document the reason for the CBC and any relevant clinical findings.

Specialty Considerations

Hematologists should ensure that the differential count is clearly documented.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of conditions like neutropenic splenomegaly, improving the accuracy of patient records and facilitating better management of complex cases.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like neutropenic splenomegaly, improving the accuracy of patient records and facilitating better management of complex cases.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of conditions like neutropenic splenomegaly, improving the accuracy of patient records and facilitating better management of complex cases.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What is the primary cause of neutropenic splenomegaly?

Neutropenic splenomegaly can be caused by various factors, including bone marrow disorders, autoimmune diseases, and certain infections that lead to decreased neutrophil production and splenic enlargement.