Congenital malformations of spleen

This code signifies a birth defect affecting the spleen's structure or development. It encompasses various anomalies such as accessory spleens (splenunculi), lobulated spleens, or other structural deviations present at birth. These malformations can range from clinically insignificant to those causing functional impairment.

Apply this code when documentation specifies a congenital structural abnormality of the spleen, excluding asplenia or polysplenia which have more specific codes. This code is appropriate when the malformation is identified through imaging studies (e.g., ultrasound, CT, MRI) or during surgical exploration. The physician's diagnostic statement must clearly indicate the congenital nature of the splenic anomaly.

• Do not use this code for acquired splenic conditions or functional disorders without a structural defect.
• Distinguish from Q89.01 (Congenital absence of spleen) and Q89.02 (Congenital polysplenia) when documentation specifies those conditions.
• Ensure the medical record explicitly states the splenic malformation is congenital to support this diagnosis.