2027 ICD-10-CM Diagnosis Code D61.1Drug-induced aplastic anemia

ICD-10-CM Codes›D50–D89›D60-D64›D61

ICD-10-CM D61.1
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

D61.1 is a billable ICD-10-CM diagnosis code for drug-induced aplastic anemia. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 808 through 810. As a secondary diagnosis, it counts as a major complication or comorbidity (MCC) and places an inpatient stay in the highest severity level of its MS-DRG family. It does not count, however, when the principal diagnosis is one of 110 closely related codes. Coders also document this condition as anemia caused by antineoplastic agent. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Aplastic anemia and Drug induced or toxic related condition.

D61.1 no longer risk-adjusts for Medicare Advantage: it mapped to HCC 46 under the retired CMS-HCC V24 model through payment year 2025 but maps to no category in the live V28 model. It still risk-adjusts in the PACE (CMS-HCC V22) category 46, ESRD (V21) category 46, ESRD (V24) category 46, and RxHCC Part D (V08) category 96 for payment year 2027.

Code Identity

ICD-10-CM Code
D61.1
Billable Status
Yes — Valid for Submission
Code Describes
Drug-induced aplastic anemia
Short Description
Drug-induced aplastic anemia
Same as the full description in the CMS dataset.
Parent Code
D61
Other aplastic anemias and other bone marrow failure syndromes

Code Classification

ChapterD50–D89Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism
SectionD60-D64Aplastic and other anemias and other bone marrow failure syndromes
CategoryD61Other aplastic anemias and other bone marrow failure syndromes
This CodeD61.1Drug-induced aplastic anemia

Medicare Risk Adjustment (HCC)Billing

D61.1 no longer risk-adjusts for Medicare Advantage: it maps to no payment category in the live CMS-HCC V28 model, although it still risk-adjusts in the other CMS models shown below.

CMS-HCC V28 (Medicare Advantage Payment Model)
Not mapped
Dropped in V28 see all codes that no longer risk-adjust
Prior Model (CMS-HCC V24)
HCC 46
V24 retired last contributed to a Medicare Advantage risk score in payment year 2025
Other CMS Models
PACE (CMS-HCC V22): HCC 46 · ESRD (V21): HCC 46 · ESRD (V24): HCC 46
ESRD V21 weights: 0.180 dialysis, 0.766–1.325 functioning graft · ESRD V24 weights: 0.223 dialysis, 0.748–4.064 functioning graft
Part D (RxHCC)
RxHCC 96 — Acquired Hemolytic, Aplastic, and Sideroblastic Anemias
also risk-adjusts in the Part D prescription drug model (V08)

Source: CMS Payment Year 2027 risk adjustment mappings and model software. Weights are relative factors, not dollar amounts; a beneficiary's total RAF also includes demographics and interactions. Browse all CMS-HCC categories.

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Anemia caused by antineoplastic agent
  • Aplastic anemia caused by antineoplastic agent
  • Aplastic anemia due to drugs
  • Drug-induced hypoplasia of bone marrow
  • Hypocellular bone marrow
  • Pancytopenia caused by medication

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to D61.1: its own notes plus those printed at D61 and Chapter 3. A note printed at a category, block or chapter applies to every code under it.

Excludes2

Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.

From D61 Other aplastic anemias and other bone marrow failure syndromes applies to 13 codes
From Chapter 3 (D50-D89) Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism applies to 324 codes
  • autoimmune disease (systemic) NOS (M35.9)
  • certain conditions originating in the perinatal period (P00-P96)
  • complications of pregnancy, childbirth and the puerperium (O00-O9A)
  • congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)
  • endocrine, nutritional and metabolic diseases (E00-E88)
  • human immunodeficiency virus [HIV] disease (B20)
  • injury, poisoning and certain other consequences of external causes (S00-T88)
  • neoplasms (C00-D49)
  • symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)

Use Additional Code

Add a second code, after this one, to fully describe the condition.

  • code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5)

Source: CMS ICD-10-CM Tabular List. How to read instructional notes.

Referenced in Other NotesGuidance

Instructional notes printed at other codes that name D61.1, its category, or a range that includes it.

Excludes1 1

These codes carry an Excludes1 note naming D61.1: they are not reported together with it, unless the two conditions are unrelated.

  • D63.0 Anemia in neoplastic disease
    aplastic anemia due to antineoplastic chemotherapy (D61.1)

Excludes2 4

These codes carry an Excludes2 note naming D61.1: its condition is not part of those codes, and both may be reported when the patient has both.

  • D46 Myelodysplastic syndromes
    drug-induced aplastic anemia (D61.1)
  • D61.810 Antineoplastic chemotherapy induced pancytopenia
    aplastic anemia due to antineoplastic chemotherapy (D61.1)
  • D61.811 Other drug-induced pancytopenia
    aplastic anemia due to drugs (D61.1)
  • D64.81 Anemia due to antineoplastic chemotherapy
    aplastic anemia due to antineoplastic chemotherapy (D61.1)

Index to Diseases and InjuriesGuidance

Alphabetical index entries that point to this code.

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR BLD003
Aplastic anemia
Default principal diagnosis: inpatient No · outpatient No
CCSR INJ030
Drug induced or toxic related condition
Default principal diagnosis: inpatient Yes · outpatient Yes

Clinical InformationClinical

  • Drug-Induced Aplastic Anemia

    a state of bone marrow suppression and failure that is caused by a cytotoxic or adverse immunologic response to a drug treatment, leading to a failure of production of red blood cells, white cells and platelets.

Patient EducationClinical

Aplastic Anemia

Aplastic anemia is a rare but serious blood disorder. If you have it, your bone marrow doesn't make enough new blood cells. It happens when there is damage to stem cells inside your bone marrow. There are different types of aplastic anemia, including Fanconi anemia.

The full article covers:

  • What is aplastic anemia?
  • What causes aplastic anemia?
  • What are the symptoms of aplastic anemia?
  • What other problems can aplastic anemia cause?
  • How is aplastic anemia diagnosed?
  • What are the treatments for aplastic anemia?

Read the full article at MedlinePlus

Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.

Convert D61.1 to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
284.89 Aplastic anemias NEC
Approximate The match is approximate rather than exact.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2026No changes
FY 2027CurrentCurrent code set, no changesEffective October 1, 2026 through September 30, 2027.

Questions About D61.1Overview

What is the ICD-10 code for drug-induced aplastic anemia?

The ICD-10-CM code for drug-induced aplastic anemia is D61.1 (sometimes written as D611). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

Is D61.1 a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report drug-induced aplastic anemia on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

What MS-DRG does D61.1 group to?

When drug-induced aplastic anemia is the principal diagnosis on an inpatient stay, it groups to MS-DRG 808, 809, 810, with relative weights from 1.0749 to 2.1706 depending on complications. Higher weights mean higher Medicare reimbursement.

Is D61.1 a CC or MCC?

CMS lists D61.1 as an MCC (major complication or comorbidity) for FY 2027. Reported as a secondary diagnosis, it places the inpatient stay in the highest-weighted DRG of its severity family. It does not count when the principal diagnosis is one of the 110 closely related codes in its exclusion list.

Does D61.1 need an additional code?

When the condition applies, yes. The Use Additional Code note reads: code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5). The additional code is reported after D61.1.

Does D61.1 risk-adjust for Medicare Advantage payment?

Not for Medicare Advantage. D61.1 mapped to HCC 46 in the retired CMS-HCC V24 model, which last determined payment in 2025, but it maps to no category in the live V28 model; see all codes that no longer risk-adjust. It still risk-adjusts in the PACE (CMS-HCC V22) category 46 (Severe Hematological Disorders), ESRD (V21) category 46 (Severe Hematological Disorders), ESRD (V24) category 46 (Severe Hematological Disorders), and RxHCC Part D (V08) category 96 (Acquired Hemolytic, Aplastic, and Sideroblastic Anemias).