2025 ICD-10-CM code D78.89
This code describes complications arising after spleen procedures, specifically those not covered by other, more specific codes.
Medical necessity for services related to post-procedural complications must be supported by documentation that establishes the need for intervention due to the complication, connecting it directly to the original splenic procedure.
Clinicians should diagnose this condition based on physical examination, patient-reported symptoms (pain, discomfort, swelling), and laboratory or imaging results (CBC, coagulation tests, CT scan, ultrasound). Treatment may involve splenectomy, suturing, blood transfusion, fluid resuscitation, and supportive care.
- Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism (D50-D89)
- D78-D78.89
In simple words: This code is used when there are complications after surgery or other procedures on the spleen, covering issues not specifically described by other codes.
This code represents other postprocedural complications of the spleen, indicating complications that occur after a procedure involving the spleen, beyond the immediate intraoperative period. It encompasses complications not specifically addressed by other codes within the D78 category.
Example 1: A patient experiences persistent bleeding several days after a splenectomy, requiring a blood transfusion. This is a postprocedural complication not otherwise specified and would be coded as D78.89., Following a partial splenectomy, a patient develops an abscess at the surgical site.This localized infection is a post-procedural complication and would be coded with D78.89, along with an additional code to specify the abscess., A patient undergoes splenic artery embolization for a ruptured spleen.Several weeks later, they develop a persistent, low-grade fever and discomfort.After further investigation, it's determined they have a subcapsular hematoma.This would be coded as D78.89, potentially with an additional code for the hematoma.
Documentation should clearly describe the nature of the complication, its onset relative to the splenic procedure, diagnostic findings (physical exam, lab results, imaging studies), and treatment provided.
- Specialties:General surgery, trauma surgery, hematology, critical care
- Place of Service:Inpatient Hospital, Outpatient Hospital, Office