Is D61.811 a billable ICD-10-CM code?

Yes. D61.811 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does D61.811 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 D61.811?

D61.811 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above D61.811 (D61.81) and apply to it just the same.

D61.811

D61.811 — Other drug-induced pancytopenia

Billable / specific codeICD-10-CM

D61.811 is a billable, specific ICD-10-CM code for other drug-induced pancytopenia. It is valid for submission on a claim.

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.

aplastic anemia due to drugs (D61.1)

Excludes1 inherited from the categories above D61.811

These are not written on D61.811, but they bind it: a note on a category applies to every code beneath it. Billing D61.811 with anything listed here is a denial.

Written on D61.81 — Pancytopenia

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 inherited from the categories above D61.811

Also inherited, and the opposite of Excludes1: these conditions are not part of D61.811, but a patient can have both, so you may code both.

Written on D61.81 — Pancytopenia

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

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

neutropenia (D70.-)

Risk adjustment

D61.811 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.

Medicare coverage

D61.811 is named in 18 Medicare coverage policies — 18 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A55717Billing and Coding: Lab: Flow Cytometry
A56421Billing and Coding: CT of the Abdomen and Pelvis
A56464Billing and Coding: Flow Cytometry
A56718Billing and Coding: Intravenous Immunoglobulin (IVIG)

How D61.811 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 D61.811.

Pancytopenia›drug-induced NEC

Code history

D61.811 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Related codes at this level

Codes that share D61.81. If D61.811 is not quite right, the correct code is usually one of these.

Questions about D61.811

Is D61.811 a billable ICD-10-CM code?: Yes. D61.811 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does D61.811 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 D61.811?: D61.811 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above D61.811 (D61.81) and apply to it just the same.