D61.01: Constitutional (pure) red blood cell aplasia
D61.01 is a billable, specific ICD-10-CM code for constitutional (pure) red blood cell aplasia. It is valid for submission on a claim.
Check D61.01 with the rest of the claim: free scrubberExcludes1: never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
- acquired red cell aplasia (D60.9)
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Blackfan-Diamond syndrome
- Congenital (pure) red cell aplasia
- Familial hypoplastic anemia
- Primary (pure) red cell aplasia
- Red cell (pure) aplasia of infants
Other codes that can never be billed with D61.01
Their own Excludes1 notes name this code, so the conflict is not listed above.
Risk adjustment
D61.01 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 109 Acquired Hemolytic, Aplastic, and Sideroblastic Anemias1.144 RAF
Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score. Look up the whole chart to see which of its HCCs the hierarchy would zero.
Medicare coverage
D61.01 is named in 16 Medicare coverage policies: 16 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A52986Billing and Coding: Biomarkers for Oncology
- A55717Billing and Coding: Lab: Flow Cytometry
- A56199Billing and Coding: Molecular Pathology Procedures
- A56464Billing and Coding: Flow Cytometry
Alphabetic index entries that lead here
- Blackfan-Diamond anemia or syndrome(congenital hypoplastic anemia)
- Diamond-Blackfan anemia(congenital hypoplastic)
- Joseph-Diamond-Blackfan anemia(congenital hypoplastic)
- Kaznelson's syndrome(congenital hypoplastic anemia)
- Anemia›Diamond-Blackfan(congenital hypoplastic)
- Anemia›Joseph-Diamond-Blackfan(congenital hypoplastic)
- Aplasia›congenital pure red cell
- Aplasia›erythrocyte congenital
- Erythroblastopenia›congenital
- Hypoplasia, hypoplastic›erythroid, congenital
- Syndrome›Blackfan-Diamond
- Syndrome›Diamond-Blackfan
Code history
Unchanged in every release from FY2024 to FY2027.