D61.89: Other specified aplastic anemias and other bone marrow failure syndromes

Risk adjustment

D61.89 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

D61.89 is named in 34 Medicare coverage policies: 34 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
• A56199Billing and Coding: Molecular Pathology Procedures
• A56464Billing and Coding: Flow Cytometry