ICD-10 D61.81
Non-Billable HeaderPancytopenia
About ICD-10-CM D61.81
ICD-10-CM code D61.81 represents Pancytopenia. This is a non-billable header code in the Blood and Blood-forming Organs chapter (block D61). The 2026 edition of ICD-10-CM D61.81 became effective on October 1, 2025. Non-billable codes cannot be used as a primary or secondary diagnosis on a claim, use a more specific child code instead.
Type 1 Excludes
Pure excludes, these codes can never be coded together with D61.81. The conditions are mutually exclusive (e.g., congenital vs acquired forms).
- 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)
Type 2 Excludes
Not included here, the excluded code is not part of D61.81, but a patient may have both conditions at the same time. Both codes may be coded together when applicable.
- pancytopenia (due to) (with) myelodysplastic syndromes (D46.-)
Medicare LCD Coverage for D61.81
Local Coverage Determinations (LCDs) from CMS MACs that list D61.81 as a covered diagnosis.
This doesn't mean the code isn't covered, it means no MAC has issued a Local Coverage Determination naming this specific code. Coverage may still apply under National Coverage Determinations or general medical-necessity rules.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing D61.81.
Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but D61.81 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.
CPT Codes Commonly Billed with D61.81
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.
Codes Adjacent To D61.81
Other codes in section D60-D64 (Aplastic and other anemias and other bone marrow failure syndromes).
ICD-10 D61.81, Billing FAQ
Is ICD-10 code D61.81 billable? +
No, D61.81 is a non-billable header code. Use a more specific child code from block D61 when submitting claims.
What codes are Type 1 Excludes for D61.81? +
Type 1 Excludes (never code together with D61.81): 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)
What codes are Type 2 Excludes for D61.81? +
Type 2 Excludes (may be coded together when both conditions exist): pancytopenia (due to) (with) myelodysplastic syndromes (D46.-)
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on June 1, 2026.
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