D61.02

D61.02: Shwachman-Diamond syndrome

Billable / specific codeICD-10-CM

D61.02 is a billable, specific ICD-10-CM code for shwachman-diamond syndrome. It is valid for submission on a claim.

Check D61.02 with the rest of the claim: free scrubber

Use additional code

Add a secondary code to capture the detail described below.

code, if applicable, for genetic susceptibility to other malignant neoplasm (Z15.09)

Code also

Both codes may be needed to describe the encounter fully. Sequencing depends on the reason for the visit.

, if applicable, associated conditions such as:
acute myeloblastic leukemia (C92.0-)
exocrine pancreatic insufficiency (K86.81)
myelodysplastic syndrome (D46.-)

Excludes2 inherited from the categories above D61.02

Not part of this code, but both may be coded when both are present.

Written on D61: Other aplastic anemias and other bone marrow failure syndromes

neutropenia (D70.-)

Risk adjustment

D61.02 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

D61.02 is named in 6 Medicare coverage policies: 6 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

A55717Billing and Coding: Lab: Flow Cytometry
A56718Billing and Coding: Intravenous Immunoglobulin (IVIG)
A57110Billing and Coding: MolDX: Blood Product Molecular Antigen Typing
A57124Billing and Coding: MolDX: Blood Product Molecular Antigen Typing

Alphabetic index entries that lead here

Syndrome›Schwachman(-Diamond)
Syndrome›Shwachman(-Diamond)

Code history

Unchanged in every release from FY2024 to FY2027.