D61.03

D61.03: Fanconi anemia

Billable / specific codeICD-10-CM

D61.03 is a billable, specific ICD-10-CM code for fanconi anemia. It is valid for submission on a claim.

Check D61.03 with the rest of the claim: free scrubber

Excludes1: never code together

These conditions cannot occur together. Billing both on the same encounter is a denial.

Fanconi syndrome (E72.0-)

Inclusion terms

Alternative wordings a physician may use in the chart for this same code.

Fanconi pancytopenia
Fanconi's anemia

Excludes2 inherited from the categories above D61.03

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

D61.03 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

D61.03 is named in 22 Medicare coverage policies: 22 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
A57110Billing and Coding: MolDX: Blood Product Molecular Antigen Typing
A57124Billing and Coding: MolDX: Blood Product Molecular Antigen Typing

Alphabetic index entries that lead here

Fanconi anemia('s)
Fanconi hypoplastic anemia
Fanconi panmyelopathy
Anemia›Fanconi('s)
Disease, diseased›Fanconi('s)
Pancytopenia›Fanconi

Code history

addedFY2024-FY2027
Fanconi anemia