D73.5 ICD-10-CM Code: Infarction of spleen
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Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.
FY 2026 Apr update / Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism (D50-D89) / Other disorders of blood and blood-forming organs (D70-D77)
D73.5
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceInfarction of spleen
This condition occurs when blood flow to the spleen is blocked, causing part or all of the spleen tissue to die due to lack of oxygen. It's a serious condition that can cause severe abdominal pain and may require emergency treatment.
CMS-HCC V28
00
RAF 0
CMS-HCC V24
00
RAF 0
ACA/HHS
00
RAF 0
ESRD/PACE
00
RAF 0
RXHCC
00
RAF 0
Code Trumping
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Code Book Path
Inclusion Terms
Official- Splenic rupture, nontraumatic
- Torsion of spleen
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for D73.5 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for D73.5 in this effective period.
Excludes 1
Official- rupture of spleen due to Plasmodium vivax malaria (B51.0)
- traumatic rupture of spleen (S36.03-)
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for D73.5 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for D73.5 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for D73.5 in this effective period.
Buddy Documentation Tip
Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.
Is D73.5 an HCC code?
No. D73.5 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
D73.5 is the ICD-10-CM diagnosis code for infarction of spleen. This condition occurs when blood flow to the spleen is blocked, causing part or all of the spleen tissue to die due to lack of oxygen. It's a serious condition that can cause severe abdominal pain and may require emergency treatment. D73.5 sits in the ICD-10-CM chapter for diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism (d50-d89), within the section covering other disorders of blood and blood-forming organs (d70-d77).
D73.5 is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.
Ensure the infarction is specifically documented as affecting the spleen; do not confuse with other organ infarctions.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for D73.5 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Ensure the infarction is specifically documented as affecting the spleen; do not confuse with other organ infarctions
- •Investigate the underlying cause (such as splenic artery thrombosis, embolism, or trauma) as this may require additional coding and can impact treatment decisions