ICD-10 Coding for Aplastic Anemia(D61.0, D61.1, D61.9)
Complete ICD-10-CM coding and documentation guide for Aplastic Anemia. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Aplastic Anemia
D61.0-D61.9Primary Range
Aplastic Anemias
This range covers all types of aplastic anemia, including drug-induced, radiation-induced, and unspecified causes.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| D61.0 | Aplastic anemia due to drugs | Use when aplastic anemia is confirmed to be caused by specific drugs or chemicals. |
|
| D61.1 | Aplastic anemia due to radiotherapy/chemotherapy | Use when aplastic anemia is confirmed to be caused by chemotherapy or radiotherapy. |
|
| D61.9 | Unspecified aplastic anemia | Use when the cause of aplastic anemia is not specified in the documentation. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for aplastic anemia
Essential facts and insights about Aplastic Anemia
Primary ICD-10-CM Codes for aplastic anemia
Decision Criteria
clinical Criteria
- Confirmed drug exposure with bone marrow biopsy showing hypocellularity.
Applicable To
- Aplastic anemia due to benzene
- Aplastic anemia due to chloramphenicol
Excludes
- Radiation-induced aplastic anemia (D61.1)
Clinical Validation Requirements
- Bone marrow biopsy showing hypocellularity
- History of drug exposure
Code-Specific Risks
- Misidentifying the cause as drug-induced without proper documentation.
Coding Notes
- Ensure documentation specifies the drug or chemical responsible for the anemia.
D61.1 - Aplastic anemia due to radiotherapy/chemotherapy
Use when aplastic anemia is confirmed to be caused by chemotherapy or radiotherapy.
Applicable To
- Aplastic anemia due to chemotherapy
- Aplastic anemia due to radiotherapy
Excludes
- Drug-induced aplastic anemia (D61.0)
Clinical Validation Requirements
- Bone marrow biopsy showing hypocellularity
- History of chemotherapy or radiotherapy
Coding Notes
Sequence the anemia code first, followed by the malignancy and adverse effect codes.
D61.9 - Unspecified aplastic anemia
Use when the cause of aplastic anemia is not specified in the documentation.
Applicable To
- Aplastic anemia NOS
Excludes
- Specific causes of aplastic anemia (D61.0-D61.1)
Clinical Validation Requirements
- Bone marrow biopsy showing hypocellularity
- No identifiable cause documented
Coding Notes
Query the provider if the cause of anemia is unclear.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Aplastic Anemia to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code D61.0.
Impact
Clinical: Leads to incorrect treatment plans., Regulatory: Non-compliance with coding standards., Financial: Potential for reduced reimbursement.
Mitigation Strategy
Always document the cause if known., Use specific codes when the cause is identified.
Impact
Reimbursement: May result in lower reimbursement due to lack of specificity., Compliance: Non-compliance with coding guidelines., Data Quality: Decreases accuracy of clinical data.
Mitigation Strategy
Ensure the cause of aplastic anemia is clearly documented and use the specific code.
Impact
Using unspecified codes when specific causes are documented.
Mitigation Strategy
Ensure thorough documentation of the cause of anemia.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Aplastic Anemia, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Aplastic Anemia
Use these documentation templates to ensure complete and accurate documentation for Aplastic Anemia. These templates include all required elements for proper coding and billing.
Chemotherapy-induced aplastic anemia
Specialty: HematologyRequired Elements
- Bone marrow biopsy results
- Chemotherapy exposure history
- CBC results showing pancytopenia
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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