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D70 vs R78.8

D70 (Neutropenia) compared with R78.8 (Finding of other specified substances, not normally found in blood), 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 R78.8 lists D70 under Excludes2, which marks them as distinct conditions.

Official rule
What is different?

The conditions named and chapter.D70 is “Neutropenia”; R78.8 is “Finding of other specified substances, not normally found in blood”. D70 sits in D50-D89 — Diseases of the Blood and Blood-forming Organs and Certain Disorders Involving the Immune Mechanism (D50-D89); R78.8 in R00-R99 — Symptoms, Signs and Abnormal Clinical and Laboratory Findings, Not Elsewhere Classified (R00-R99).

Registry fact

Can these codes be reported together?

Yes, when both are documented.R78.8 lists D70 under Excludes2: “abnormalities of white blood cells classified elsewhere (D70-D72)”. Excludes2 marks distinct conditions that may both be reported when both are documented.

Official ruleGuide: Excludes1 vs Excludes2

Is there an Excludes2 relationship?

Yes.R78.8’s tabular entry: “abnormalities of white blood cells classified elsewhere (D70-D72)”. The note covers D70.

Official ruleGuide: Excludes1 vs Excludes2

Is one a parent or header code?

Both are headers.Both are non-billable headers, and neither contains the other.

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. D70 carries 2 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

R78.8
Finding of other specified substances, not normally found in blood
↔
D70
Neutropenia

What we found

Yes, when both are documented.R78.8 carries an Excludes2 note covering D70: “abnormalities of white blood cells classified elsewhere (D70-D72)”

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
D70

Neutropenia

R78.8

Finding of other specified substances, not normally found in blood

StatusDiffers
D70
Non-billable header

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

Report instead: D70.0, D70.1, D70.2, D70.3, D70.4

R78.8
Non-billable header

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

Report instead: R78.81, R78.89

Excludes1Differs
D70
  • neutropenic splenomegaly (D73.81)
  • transient neonatal neutropenia (P61.5)
R78.8

None at this code

Excludes2Differs
D70

None at this code

R78.8
  • mental or behavioral disorders due to psychoactive substance use (F10-F19)
  • abnormal findings on antenatal screening of mother (O28.-)
  • abnormalities of lipids (E78.-)
  • abnormalities of platelets and thrombocytes (D69.-)
  • abnormalities of white blood cells classified elsewhere (D70-D72)
  • coagulation hemorrhagic disorders (D65-D68)
  • diagnostic abnormal findings classified elsewhere - see Alphabetical Index
  • hemorrhagic and hematological disorders of newborn (P50-P61)
Use additional codeDiffers
D70
  • code for any associated:
  • fever (R50.81)
R78.8
  • code to identify any retained foreign body, if applicable (Z18.-)
Code alsoDiffers
D70
  • , if applicable, mucositis (J34.81, K12.3-, K92.81, N76.81)
R78.8

None at this code

CategoryDiffers
D70

Is itself a category

R78.8

R78 Findings of drugs and other substances, not normally found in blood

ChapterDiffers
D70

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

R78.8

R00-R99 — Symptoms, Signs and Abnormal Clinical and Laboratory Findings, Not Elsewhere Classified (R00-R99)

IncludesDiffers
D70
  • agranulocytosis
  • decreased absolute neurophile count (ANC)
R78.8

None at this code

No Code first 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