2027 ICD-10-CM Diagnosis Code D61.811Other drug-induced pancytopenia

ICD-10-CM Codes›D50–D89›D60-D64›D61

ICD-10-CM D61.811
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

D61.811 is a billable ICD-10-CM diagnosis code for other drug-induced pancytopenia. 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 41 closely related codes. Coders also document this condition as acquired pancytopenia. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Aplastic anemia and Drug induced or toxic related condition.

D61.811 no longer risk-adjusts for Medicare Advantage: it mapped to HCC 47 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 47, ESRD (V21) category 47, and ESRD (V24) category 47 for payment year 2027.

Code Identity

ICD-10-CM Code
D61.811
Billable Status
Yes — Valid for Submission
Code Describes
Other drug-induced pancytopenia
Short Description
Other drug-induced pancytopenia
Same as the full description in the CMS dataset.
Parent Code
D61.81
Pancytopenia

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 CodeD61.811Other drug-induced pancytopenia

Medicare Risk Adjustment (HCC)Billing

D61.811 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 47
V24 retired last contributed to a Medicare Advantage risk score in payment year 2025
Other CMS Models
PACE (CMS-HCC V22): HCC 47 · ESRD (V21): HCC 47 · ESRD (V24): HCC 47
ESRD V21 weights: 0.097 dialysis, 0.549–0.688 functioning graft · ESRD V24 weights: 0.078 dialysis, 0.523–0.803 functioning graft
Part D (RxHCC)
Not mapped
D61.811 does not risk-adjust in the RxHCC prescription drug model

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.

  • Acquired pancytopenia
  • Pancytopenia caused by anticonvulsant
  • Pancytopenia caused by antidiabetic drug
  • Pancytopenia caused by antithyroid drug
  • Pancytopenia caused by colchicine
  • Pancytopenia caused by immunosuppressant
  • Pancytopenia caused by medication
  • Pancytopenia caused by non-steroidal anti-inflammatory agent

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to D61.811: its own notes plus those printed at D61.81, D61, and Chapter 3. A note printed at a category, block or chapter applies to every code under it.

Excludes1

Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.

From D61.81 Pancytopenia applies to 3 codes
  • 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: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.

On D61.811 itself
  • aplastic anemia due to drugs (D61.1)
From D61.81 Pancytopenia applies to 3 codes
  • pancytopenia (due to) (with) myelodysplastic syndromes (D46.-)
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)

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

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

  • Pancytopenia

    deficiency of all three cell elements of the blood, erythrocytes, leukocytes and platelets.

Patient EducationClinical

Blood Disorders

Your blood is living tissue made up of liquid and solids. The liquid part, called plasma, is made of water, salts and protein. Over half of your blood is plasma. The solid part of your blood contains red blood cells, white blood cells and platelets.

Read the full article at MedlinePlus

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

Convert D61.811 to ICD-9-CMHistory

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

ICD-9-CM
284.12 Oth drg indcd pancytopna
Exact Match The mapping is direct, with no qualifiers.

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 D61.811Overview

What is the ICD-10 code for other drug-induced pancytopenia?

The ICD-10-CM code for other drug-induced pancytopenia is D61.811 (sometimes written as D61811). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

Is D61.811 (Pancytopenia) a billable code?

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

What MS-DRG does D61.811 group to?

When other drug-induced pancytopenia 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 D61.811 a CC or MCC?

CMS lists D61.811 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 41 closely related codes in its exclusion list.

Can D61.811 be reported with D61.9?

Not as a rule. The Excludes1 note at D61.81, which applies to D61.811, lists "pancytopenia (due to) (with) aplastic anemia (D61.9)". An Excludes1 note means the excluded code is never reported together with this one; the only exception is when the two conditions are unrelated to each other (Official Guidelines, Section I.A.12.a).

Does D61.811 risk-adjust for Medicare Advantage payment?

Not for Medicare Advantage. D61.811 mapped to HCC 47 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 47 (Disorders of Immunity), ESRD (V21) category 47 (Disorders of Immunity), and ESRD (V24) category 47 (Disorders of Immunity).