Question 1

What is ICD-10 code D78.01?

Accepted Answer

D78.01 is the ICD-10-CM diagnosis code for intraoperative hemorrhage and hematoma of the spleen complicating a procedure on the spleen. Unexpected bleeding or blood collection in the spleen that occurs during surgery on the spleen itself. D78.01 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 intraoperative and postprocedural complications of the spleen (d78).

D78.01 is a billable ICD-10-CM code, but the current payload does not show a mapping under the CMS-HCC V28 or V24 community payment models, and none under the ESRD, Part D RxHCC, or HHS-HCC models. Do not assign risk adjustment value from this page when no source-backed mapping is shown; verify the applicable model and payment year.

Use only when the procedure performed was on the spleen.

Question 2

Is D78.01 an HCC code?

Accepted Answer

D78.01 has no payable CMS-HCC V28 mapping in the final FY2026 CMS file.

Question 3

Is D78.01 billable?

Accepted Answer

Yes. D78.01 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. D78.01 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

Question 4

Which HCC does D78.01 map to under V28?

Accepted Answer

D78.01 has no payable CMS-HCC V28 mapping in the final FY2026 CMS file.

Question 5

What RAF reference is published for D78.01?

Accepted Answer

D78.01 has no V28 reference coefficient because the final FY2026 source verifies no payable V28 mapping.

Question 6

What is the V28 vs V24 difference for D78.01?

Accepted Answer

D78.01 has verified no payable V28 mapping in the final FY2026 source. Select a historical effective period before making any V24 comparison.

Question 7

What documentation supports D78.01?

Accepted Answer

Use only when the procedure performed was on the spleen Include the specific surgical procedure code to provide complete documentation D78.01 is not a CMS-HCC V28 payment code in the verified current source, so MEAT is not the payment hook. Documentation still has to support the diagnosis if you report it.

Question 8

Can D78.01 be a primary diagnosis?

Accepted Answer

Yes. D78.01 carries no code-first instruction in the FY2026 tabular, so it can be the first-listed diagnosis when it is the condition chiefly responsible for the encounter and the note supports it, and it can also be reported as a secondary diagnosis. For risk adjustment the order does not matter; the V28 category is the same either way.

Question 9

Which codes cannot be reported with D78.01?

Accepted Answer

The Excludes1 note that applies to D78.01 lists intraoperative hemorrhage and hematoma of the spleen due to accidental puncture or laceration during a procedure (D78.1-). An Excludes1 condition is not reported together with D78.01; report one or the other, unless the two conditions are unrelated, which the ICD-10-CM Official Guidelines (Section I.A.12.a) allow. The Excludes2 note lists autoimmune disease (systemic) NOS (M35.9); certain conditions originating in the perinatal period (P00-P96); complications of pregnancy, childbirth and the puerperium (O00-O9A); congenital malformations, deformations and chromosomal abnormalities (Q00-Q99); and 5 more (see the notes on this page); those are separate conditions that may be reported together with D78.01 when both are documented.

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D78.01

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D78.01 ICD-10-CM Code: Intraoperative hemorrhage and hematoma of the spleen complicating a procedure on the spleen

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D78.01

Is D78.01 an HCC code?

Get the V28 mapping + MEAT cheat sheet

What This Code Means

Coding Tips

Child Codes

Code Hierarchy

Also searched as

Work D78.01 in HCC Buddy