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D46 vs D61.810

D46 (Myelodysplastic syndromes) compared with D61.810 (Antineoplastic chemotherapy induced pancytopenia), from the official CMS tabular data.

Current data releases:ICD-10-CM FY2027 · ICD-10-PCS FY2027 · HCPCS October 2026 · MS-DRG v44 · Medicare Code Editor v44.0 · NCCI PTP Q4 2026 · MUE Q4 2026 · NCD code lists 2026-01 · LCD export September 28, 2026 · All releases and sources

Summary

These codes can be reported together when both conditions are documented, because D61.810 lists D46 under Excludes2, which marks them as distinct conditions.

Official rule
What is different?

The conditions named, billing status and chapter.D46 is “Myelodysplastic syndromes”; D61.810 is “Antineoplastic chemotherapy induced pancytopenia”. D46 is a non-billable header; D61.810 is billable. D46 sits in C00-D49 — Neoplasms (C00-D49); D61.810 in D50-D89 — Diseases of the Blood and Blood-forming Organs and Certain Disorders Involving the Immune Mechanism (D50-D89).

Registry fact

Can these codes be reported together?

Yes, when both are documented.D61.810 lists D46 under Excludes2: “pancytopenia (due to) (with) myelodysplastic syndromes (D46.-)”. Excludes2 marks distinct conditions that may both be reported when both are documented.

Official ruleGuide: Excludes1 vs Excludes2

Is there an Excludes2 relationship?

Yes.D61.810’s tabular entry: “pancytopenia (due to) (with) myelodysplastic syndromes (D46.-)”. The note covers D46.

Official ruleGuide: Excludes1 vs Excludes2

Is one a parent or header code?

One is a header.D46 is a non-billable header, but D61.810 is not one of its subdivisions.

Registry fact

Nothing found in 3 other checks; 1 check does not apply
Is there an Excludes1 relationship?

None.Neither entry carries an Excludes1 note that names the other code. D46 carries 1 Excludes1 note and D61.810 carries 7 Excludes1 notes covering other codes; the side-by-side table quotes them.

Official rule

Is one more specific?

Not comparable.The codes sit in different categories; specificity is only comparable within one category.

Are there sequencing instructions?

None.Neither entry carries a Code First or Use Additional Code note that names the other.

Official rule

Are there other coding relationships?

None found.No laterality, encounter-phase, Table of Neoplasms, Table of Drugs and Chemicals, or history-versus-active-disease relationship links these codes.

MedCoder-derived

Official rule: a tabular instructional note or a section of the ICD-10-CM Official Guidelines, quoted as published. Registry fact: the codes’ own published attributes (titles, billable status, position in the hierarchy, code set). MedCoder-derived: a reading MedCoder computes from those facts; it is not itself a rule. How to read the labels

Can these codes be reported together?

Informational

Excludes2 relationship

D61.810
Antineoplastic chemotherapy induced pancytopenia
↔
D46
Myelodysplastic syndromes

What we found

Yes, when both are documented.D61.810 carries an Excludes2 note covering D46: “pancytopenia (due to) (with) myelodysplastic syndromes (D46.-)”

Excludes2 marks distinct conditions — both may be reported when both are documented.

What to review

Report both only when the documentation supports both conditions; otherwise report the one documented.

Guide: Excludes1 vs Excludes2Check these on a claim

Why it matters

An Excludes2 note means the excluded condition is not part of the code above it, but a patient can have both. Report both when both are documented.

Source / rule

CMS ICD-10-CM tabular instructional notes

Official guidance behind these answers

  • Section I.A.12.b — Excludes2 · applies to: Excludes2

    A type 2 Excludes note represents “Not included here.” An excludes2 note indicates that the condition excluded is not part of the condition represented by the code, but a patient may have both conditions at the same time. When an Excludes2 note appears under a code, it is acceptable to use both the code and the excluded code together, when appropriate.

    ICD-10-CM Official Guidelines FY2027

Quoted from the ICD-10-CM Official Guidelines for Coding and Reporting in effect for the release shown. The tabular notes above are the code-level instruction; these sections are the convention that says how such a note is applied. Source document (CMS PDF) · Release and checksum

Side by side

Similar descriptions do not make codes interchangeable. The documentation and the official instructions decide which code applies.

Official descriptionDiffers
D46

Myelodysplastic syndromes

D61.810

Antineoplastic chemotherapy induced pancytopenia

StatusDiffers
D46
Non-billable header

A header is not reported on a claim; a code beneath it is.

Report instead: D46.0, D46.1, D46.20, D46.21, D46.22

D61.810
Billable
Excludes1Differs
D46
  • neoplasms of unspecified behavior (D49.-)
D61.810
  • 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)
Excludes2Differs
D46
  • drug-induced aplastic anemia (D61.1)
D61.810
  • aplastic anemia due to antineoplastic chemotherapy (D61.1)
  • pancytopenia (due to) (with) myelodysplastic syndromes (D46.-)
  • neutropenia (D70.-)
Use additional codeDiffers
D46
  • code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5)
D61.810

None at this code

CategoryDiffers
D46

Is itself a category

D61.810

D61 Other aplastic anemias and other bone marrow failure syndromes

ChapterDiffers
D46

C00-D49 — Neoplasms (C00-D49)

D61.810

D50-D89 — Diseases of the Blood and Blood-forming Organs and Certain Disorders Involving the Immune Mechanism (D50-D89)

No Code first, Code also, Includes and 7th character note at either code.

Notes are the code’s own tabular entry, quoted as published. A note that names the other code is the one the verdict above rests on. In a row that differs, each code’s own notes are listed under it, and the notes every code shares are listed once beneath them.

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Derived from the official CMS ICD-10-CM tabular data (FY2027). A coding-rule comparison, not billing advice: payer-specific edits and medical-necessity policy are outside its scope. All data sources