2025 ICD-10-CM code A18.85
(Valid) Effective Date: N/A Certain infectious and parasitic diseases - Tuberculosis 1 Feed
Tuberculosis of the spleen.
Medical necessity for services related to A18.85 is established by the diagnosis of tuberculosis of the spleen confirmed through clinical findings, imaging studies, and laboratory tests. Treatment is medically necessary to prevent complications, including further dissemination of the disease and potentially life-threatening conditions. Surgical intervention is medically necessary if indicated due to severity or lack of response to medical treatment.
Physicians diagnose and manage tuberculosis of the spleen using a combination of physical examination, diagnostic testing (tuberculin skin test, imaging studies, and tissue biopsy), and medication. They may also perform surgical interventions when necessary.
In simple words: Tuberculosis (TB) of the spleen is uncommon and happens when TB bacteria spread to the spleen from another infected area, usually the lungs. The spleen helps filter your blood. This type of TB can cause belly pain, fever, and weight loss. Doctors diagnose it with a physical exam, skin test, imaging scans, and by testing a small sample of spleen tissue. Treatment usually involves multiple antibiotics and, sometimes, surgery.
Tuberculosis of the spleen is a rare form of extrapulmonary tuberculosis that affects the spleen. It results from the reactivation of Mycobacterium tuberculosis or, rarely, Mycobacterium bovis bacilli lodged in the spleen after migrating through the blood from an original infection site. Symptoms may include abdominal pain, fever, and weight loss. Diagnosis is based on physical examination (splenomegaly), tuberculin skin test, medical history, and imaging (MRI or CT scan). Definitive diagnosis requires histological analysis of a tissue biopsy for acid-fast bacilli. Treatment involves antituberculous chemotherapy (isoniazid, rifampin, rifabutin, pyrazinamide, and ethambutol), with other drugs considered if these are ineffective. Surgical intervention may be necessary in severe cases.
Example 1: A patient presents with fever, weight loss, and left upper quadrant abdominal pain. Upon examination, splenomegaly is noted. Imaging reveals granulomas in the spleen. Biopsy confirms the presence of Mycobacterium tuberculosis., An immunocompromised individual with a history of pulmonary tuberculosis develops abdominal discomfort and fever. CT scan shows multiple hypodense lesions in the spleen consistent with disseminated tuberculosis., A patient undergoing a splenectomy for an unrelated condition is found to have granulomas in the spleen upon pathological examination. Subsequent tests reveal Mycobacterium tuberculosis, indicating previously undiagnosed splenic TB.
Documentation should include evidence of splenomegaly, results of tuberculin skin test, imaging findings (ultrasound, CT, MRI), histopathological analysis of tissue biopsy, and results of acid-fast bacilli staining. Patient history, including symptoms (fever, abdominal pain, weight loss), history of tuberculosis, and immune status should also be documented.
- Specialties:Infectious Disease, Internal Medicine, General Surgery
- Place of Service:Inpatient Hospital, Outpatient Hospital, Office