Is D61.01 a billable ICD-10-CM code?

Yes. D61.01 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does D61.01 sit in the tabular list?

Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism (D50-D89), in the block Aplastic and other anemias and other bone marrow failure syndromes (D60-D64).

What cannot be coded together with D61.01?

D61.01 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.

D61.01

D61.01 — Constitutional (pure) red blood cell aplasia

Billable / specific codeICD-10-CM

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.

Excludes1 — 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

These codes carry an Excludes1 note pointing at D61.01. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading D61.01 alone.

D64.4Congenital dyserythropoietic anemia
D60Acquired pure red cell aplasia [erythroblastopenia]
D61.81Pancytopenia

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.

Medicare coverage

D61.01 is named in 16 Medicare coverage policies — 16 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A52986Billing and Coding: Biomarkers for Oncology
A55717Billing and Coding: Lab: Flow Cytometry
A56199Billing and Coding: Molecular Pathology Procedures
A56464Billing and Coding: Flow Cytometry

How D61.01 is indexed

Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to D61.01.

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

Related codes at this level

Codes that share D61.0. If D61.01 is not quite right, the correct code is usually one of these.

Questions about D61.01

Is D61.01 a billable ICD-10-CM code?: Yes. D61.01 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does D61.01 sit in the tabular list?: Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism (D50-D89), in the block Aplastic and other anemias and other bone marrow failure syndromes (D60-D64).
What cannot be coded together with D61.01?: D61.01 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.