Is D61.03 a billable ICD-10-CM code?

Yes. D61.03 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does D61.03 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 D61.03?

D61.03 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.

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.

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

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.

Medicare coverage

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

How D61.03 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 D61.03.

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

Related codes at this level

Codes that share D61.0. If D61.03 is not quite right, the correct code is usually one of these.

Questions about D61.03

Is D61.03 a billable ICD-10-CM code?: Yes. D61.03 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does D61.03 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 D61.03?: D61.03 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.