2027 ICD-10-CM Diagnosis Code D61.818Other pancytopenia

ICD-10-CM Codes›D50–D89›D60-D64›D61

ICD-10-CM D61.818
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

D61.818 is a billable ICD-10-CM diagnosis code for other 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 complication or comorbidity (CC) and moves an inpatient stay to a higher severity level within its MS-DRG family. It does not count, however, when the principal diagnosis is one of 41 closely related codes. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Aplastic anemia.

For Medicare Advantage risk adjustment, D61.818 maps to CMS-HCC Category 109 (Acquired Hemolytic, Aplastic, and Sideroblastic Anemias) under the V28 model, adding a risk factor of about 1.144 for a community, non-dual, aged beneficiary in payment year 2027.

Code Identity

ICD-10-CM Code
D61.818
Billable Status
Yes — Valid for Submission
Code Describes
Other pancytopenia
Short Description
Other 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 CodeD61.818Other pancytopenia

Medicare Risk Adjustment (HCC)Billing

D61.818 maps to a payment category in the CMS-HCC model used to risk-adjust Medicare Advantage payments. Weights are the published community factors for payment year 2027.

CMS-HCC V28 Category (Payment Model)
HCC 109— Acquired Hemolytic, Aplastic, and Sideroblastic Anemias
Payment HCC · PY 2027 one of 37 ICD-10-CM codes in this category
Risk Adjustment Factor (RAF) Weight
+1.144
community, non-dual, aged · ranges 0.529–1.815 across segments
Hierarchy
Top of its hierarchy
HCC 109 is not superseded by any other condition category
Prior Model (CMS-HCC V24)
HCC 47
V24 retired V28 pays 100% of MA risk scores since PY 2026
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
D61.818 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
  • Ataxia pancytopenia syndrome
  • Autoimmune leukopenia
  • Autoimmune pancytopenia
  • Doan-Wright syndrome
  • Hemophagocytic lymphohistiocytosis
  • Neonatal anemia
  • Neonatal disorder of hematopoietic system
  • Neonatal thrombocytopenia
  • NOCARH syndrome
  • Pancytopenia
  • Pancytopenia due to IKZF1 mutations
  • Pancytopenia with pancreatitis

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to D61.818: 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.

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.

Referenced in Other NotesGuidance

Instructional notes printed at other codes that name D61.818, its category, or a range that includes it.

Code Also 1

These codes say D61.818 may also be needed to fully describe the condition. The note gives no sequencing direction.

  • C92 Myeloid leukemia
    if applicable, pancytopenia (acquired) (D61.818)

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 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 D61.818 to ICD-9-CMHistory

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

ICD-9-CM
284.19 Other pancytopenia
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 D61.818Overview

What is the ICD-10 code for other pancytopenia?

The ICD-10-CM code for other pancytopenia is D61.818 (sometimes written as D61818). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

Is D61.818 (Pancytopenia) a billable code?

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

What MS-DRG does D61.818 group to?

When other 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 D61.818 a CC or MCC?

CMS lists D61.818 as a CC (complication or comorbidity) for FY 2027. Reported as a secondary diagnosis, it moves the inpatient stay to a higher-weighted DRG within its severity family. It does not count when the principal diagnosis is one of the 41 closely related codes in its exclusion list.

Can D61.818 be reported with D61.9?

Not as a rule. The Excludes1 note at D61.81, which applies to D61.818, 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).

What HCC is D61.818?

D61.818 (other pancytopenia) maps to CMS-HCC Category 109 (Acquired Hemolytic, Aplastic, and Sideroblastic Anemias), commonly written as HCC 109, in the CMS-HCC V28 model used for Medicare Advantage risk adjustment in payment year 2027. It mapped to HCC 47 under the retired V24 model. It also maps in the PACE (CMS-HCC V22), ESRD (V21), and ESRD (V24) models. It does not map to any RxHCC in the Part D prescription drug model.

Does D61.818 risk-adjust for Medicare Advantage payment?

Yes. When documented and reported on a Medicare Advantage encounter, D61.818 adds a risk adjustment factor of about 1.144 to the beneficiary's RAF score for a community, non-dual, aged enrollee (published V28 weights range from 0.529 to 1.815 depending on the payment segment). HCC 109 sits at the top of its hierarchy, so no other condition category supersedes it. See the full factor table on the HCC 109 category page.