ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 D70.0

Billable / Specific HCC v28: 47

Congenital agranulocytosis

D70
Block
3
Synonyms
596
LCDs
12
Payer Policies
0
Linked CPTs

About ICD-10-CM D70.0

ICD-10-CM code D70.0 represents Congenital agranulocytosis. This is a billable/specific code in the Blood and Blood-forming Organs chapter (block D70). The 2026 edition of ICD-10-CM D70.0 became effective on October 1, 2025.

Coding Tips for D70.0

Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.

HCC capture: document with MEAT each year

D70.0 is a CMS-HCC v28 risk-adjustment code (category 47). To count for the patient Risk Adjustment Factor (RAF), document the diagnosis with MEAT language each calendar year: Monitored, Evaluated, Assessed, Treated. A diagnosis on the problem list alone does not satisfy CMS RADV audit standards. Include the diagnosis in the assessment with current status and current treatment plan.

Inclusion Terms / Approximate Synonyms

Clinical terms and conditions classified under D70.0. Per CMS ICD-10-CM Tabular 2026.

  • Congenital neutropenia
  • Infantile genetic agranulocytosis
  • Kostmann's disease

Medicare Advantage HCC Impact

CMS-HCC v28 (current)
Category 47
ESRD-HCC
Category 47
RxHCC (Part D)
Category 47

Capture this diagnosis annually for accurate risk adjustment. Missed HCC captures are the #1 revenue leak in Medicare Advantage risk programs.

Medicare LCD Coverage for D70.0

Local Coverage Determinations (LCDs) from CMS MACs that list D70.0 as a covered diagnosis.

596 LCDs

Showing top 10 of 596 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Lab: Flow Cytometry
Article ID: 57689, Effective: 2025-11-06 00:00:00, 1518 covered, 0 non-covered
CPT 88189 →
CMS LCD: Billing and Coding: Lab: Flow Cytometry
Article ID: 57689, Effective: 2025-11-06 00:00:00, 1518 covered, 0 non-covered
CPT 86360 →
CMS LCD: Billing and Coding: Lab: Flow Cytometry
Article ID: 57689, Effective: 2025-11-06 00:00:00, 1518 covered, 0 non-covered
CPT 86361 →
CMS LCD: Billing and Coding: Lab: Flow Cytometry
Article ID: 57689, Effective: 2025-11-06 00:00:00, 1518 covered, 0 non-covered
CPT 88187 →
CMS LCD: Billing and Coding: Lab: Flow Cytometry
Article ID: 57689, Effective: 2025-11-06 00:00:00, 1518 covered, 0 non-covered
CPT 86363 →
CMS LCD: Billing and Coding: Lab: Flow Cytometry
Article ID: 57689, Effective: 2025-11-06 00:00:00, 1518 covered, 0 non-covered
CPT 86359 →
CMS LCD: Billing and Coding: Lab: Flow Cytometry
Article ID: 57689, Effective: 2025-11-06 00:00:00, 1518 covered, 0 non-covered
CPT 86356 →
CMS LCD: Billing and Coding: Lab: Flow Cytometry
Article ID: 57689, Effective: 2025-11-06 00:00:00, 1518 covered, 0 non-covered
CPT 88188 →
CMS LCD: Billing and Coding: Lab: Flow Cytometry
Article ID: 57689, Effective: 2025-11-06 00:00:00, 1518 covered, 0 non-covered
CPT 88184 →
CMS LCD: Billing and Coding: Lab: Flow Cytometry
Article ID: 57689, Effective: 2025-11-06 00:00:00, 1518 covered, 0 non-covered
CPT 88185 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing D70.0.

12 policies

2 Aetna

Hematopoietic Colony-Stimulating Factors (CSFs) - Medical Clinical Policy Bulletins | Aetna
Policy ID: CPB-0055
Genetic Testing
Policy ID: CPB-0140

1 Cigna

Flow Cytometry - (0538)
Policy ID: MM_0538

5 Medicare

Billing and Coding: Lab: Flow Cytometry
Policy ID: ART-55717
Billing and Coding: Flow Cytometry
Policy ID: ART-56464
Billing and Coding: White Cell Colony Stimulating Factors
Policy ID: ART-56748
Billing and Coding: Lab: Flow Cytometry
Policy ID: ART-57689
Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing
Policy ID: ART-58710

CPT Codes Commonly Billed with D70.0

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

No procedure linkages on file for D70.0

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.

Convert D70.0 to ICD-9-CM

Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.

ICD-10ICD-9Mapping Flags
D70.0 28801 00000

Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).

ICD-10 D70.0, Billing FAQ

Is ICD-10 code D70.0 billable? +

Yes, D70.0 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What other names or terms map to D70.0? +

ICD-10 D70.0 includes: Congenital neutropenia; Infantile genetic agranulocytosis; Kostmann's disease.

Does D70.0 affect Medicare Advantage HCC risk adjustment? +

Yes. D70.0 maps to CMS-HCC v28 category 47. Capture this diagnosis annually for accurate Medicare Advantage risk score.

What ICD-9 codes does D70.0 map to? +

Per CMS GEMs, D70.0 maps to ICD-9 codes: 28801. Useful for legacy data review and historical claim analysis.

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Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on May 31, 2026.

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