Is D61.81 a billable ICD-10-CM code?

No. D61.81 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does D61.81 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 D61.81?

D61.81 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.

D61.81

D61.81 — Pancytopenia

Non-billable headerICD-10-CM

D61.81 is a non-billable header ICD-10-CM code for pancytopenia. It cannot be billed on its own: choose one of the more specific child codes below.

Excludes1 — never code together

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

pancytopenia (due to) (with) aplastic anemia (D61.9)
pancytopenia (due to) (with) bone marrow infiltration (D61.82)
pancytopenia (due to) (with) congenital (pure) red cell aplasia (D61.01)
pancytopenia (due to) (with) hairy cell leukemia (C91.4-)
pancytopenia (due to) (with) human immunodeficiency virus disease (B20.-)
pancytopenia (due to) (with) leukoerythroblastic anemia (D61.82)
pancytopenia (due to) (with) myeloproliferative disease (D47.1)

Excludes2 — not included here, but may coexist

The excluded condition is not part of this code, but a patient can have both. You may code both.

pancytopenia (due to) (with) myelodysplastic syndromes (D46.-)

Risk adjustment

D61.81 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.

Code to one of these instead D61.81

3 child codes. Green means billable.

Related codes at this level

Codes that share D61.8. If D61.81 is not quite right, the correct code is usually one of these.

Questions about D61.81

Is D61.81 a billable ICD-10-CM code?: No. D61.81 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does D61.81 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 D61.81?: D61.81 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.