D61.81 ICD-10-CM Code: Pancytopenia
Billing Status: NO. This is a clinician non-billable / parent hierarchy grouping in the ICD-10-CM system.
Coding at a Glance
- Tabular directives
- 7 Excludes1 · 2 Excludes2
Coding instructions
Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for D61.81 in the official ICD-10-CM tabular list, quoted as published.
Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2026Effective: October 1, 2025
Notes without a marker are published on D61.81 itself; “inherited from” names the category or block whose note applies here.
Excludes1 — Not Coded Here
Conditions generally not reported together with this code (Excludes1) -- an error unless the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).
- pancytopenia (due to) (with) aplastic anemia (D61.9) Compare D61.81 vs D61.9 →
- pancytopenia (due to) (with) bone marrow infiltration (D61.82) Compare D61.81 vs D61.82 →
- pancytopenia (due to) (with) congenital (pure) red cell aplasia (D61.01) Compare D61.81 vs D61.01 →
- pancytopenia (due to) (with) hairy cell leukemia (C91.4-) Compare D61.81 vs C91.4 →
- pancytopenia (due to) (with) human immunodeficiency virus disease (B20.-) Compare D61.81 vs B20 →
- pancytopenia (due to) (with) leukoerythroblastic anemia (D61.82) Compare D61.81 vs D61.82 →
- pancytopenia (due to) (with) myeloproliferative disease (D47.1) Compare D61.81 vs D47.1 →
Excludes2 — Not Included Here
Conditions not covered by this code, but which may be reported alongside it when both are present.
- pancytopenia (due to) (with) myelodysplastic syndromes (D46.-) Compare D61.81 vs D46 →
- neutropenia (D70.-) inherited from D61Compare D61.81 vs D70 →
Coder workflow for D61.81
MedCoder structured workflow — derived from this code’s own official record
Before you code D61.81
- D61.81 is not reportable as written. Select the more specific code beneath it that the documentation supports. Codes are reported to the highest level of specificity the classification provides (Guidelines I.B.2).
ReviewD61.810, D61.811, D61.818
See the relationships section · Guide: How to choose an ICD-10-CM code →
- Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with D61.81. Excludes1 conditions are not reported together with this code unless the record shows they are unrelated (Guidelines I.A.12.a).
Choose the right path
- Does the documentation support one of the more specific codes beneath D61.81?
Yes → Select that code and continue the checks below on its own page.
No → D61.81 cannot be reported as written; query for the specificity its subcategory needs. - Does the documentation support a condition named in D61.81’s Excludes1 note?
Yes → Do not simply proceed: review the excluded code. Both are reported only when the record shows the two conditions are unrelated.
No → Continue.
Consider D61.81. Then confirm the code is valid for the date of service in the Verify section.
Documentation check
- The provider’s diagnostic statement
- Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).
Official instructions as workflow
Excludes1 — check before selecting D61.81(7 notes)
Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with D61.81: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.
CompareD61.9, D61.82, D61.01, C91.4, B20, D47.1
See the official tabular notes · Guidelines I.A.12.a
Excludes2 — not part of D61.81(2 notes)
Coding workflow: The conditions named in this note are not included in D61.81. When the record documents both, both may be reported; the note is a boundary, not a prohibition.
See the official tabular notes · Guidelines I.A.12.b
Coding decision scenarios
Pattern scenarios for this code’s structure — decision rules, not clinical cases
Documentation: Both the condition D61.81 describes and a condition named in its Excludes1 note are documented for the same encounter.
Coding question: Can both codes be reported?
Path: Review the Excludes1 note and the excluded code, and look for a provider statement on whether the two conditions are related.
Reason: Excludes1 means the two are not coded together; the exception is when the record shows the conditions are unrelated to each other (Guidelines I.A.12.a).
Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.
Code Overview
MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.
Verify Before Coding
From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.
Relationships & Classification
MedCoder structured relationships — computed from published CMS and AHRQ datasets
Other codes that name D61.81 or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.
Referenced by 1 Excludes1 note: R71 — Abnormality of red blood cells (via D61.-).
These codes’ tabular lists mark this diagnosis as mutually exclusive — not reported together unless the conditions are documented as unrelated.
Referenced by 23 Code First instructions across 3 chapters: I21.A1 — Myocardial infarction type 2 (via D61.-), M90.5 — Osteonecrosis in diseases classified elsewhere (via D61.-), T36 — Poisoning by, adverse effect of and underdosing of systemic antibiotics (via D61.-), T36-T39 — Antibiotics & Anti-infectives (T36-T39) (via D61.-), T36-T50 — Poisoning by, adverse effects of and underdosing of drugs, medicaments and biological substances (T36-T50) (via D61.-), T37 — Poisoning by, adverse effect of and underdosing of other systemic anti-infectives and antiparasitics (via D61.-), T38 — Poisoning by, adverse effect of and underdosing of hormones and their synthetic substitutes and antagonists, not elsewhere classified (via D61.-), T39 — Poisoning by, adverse effect of and underdosing of nonopioid analgesics, antipyretics and antirheumatics (via D61.-), T40 — Poisoning by, adverse effect of and underdosing of narcotics and psychodysleptics [hallucinogens] (via D61.-), T40-T41 — Analgesics & Antipyretics (T40-T41) (via D61.-), T41 — Poisoning by, adverse effect of and underdosing of anesthetics and therapeutic gases (via D61.-), T42 — Poisoning by, adverse effect of and underdosing of antiepileptic, sedative- hypnotic and antiparkinsonism drugs (via D61.-), T42-T43 — Anticonvulsants & Psychotropics (T42-T43) (via D61.-), T43 — Poisoning by, adverse effect of and underdosing of psychotropic drugs, not elsewhere classified (via D61.-), T44 — Poisoning by, adverse effect of and underdosing of drugs primarily affecting the autonomic nervous system (via D61.-), T44-T46 — Cardiovascular & Gastrointestinal (T44-T46) (via D61.-), T45 — Poisoning by, adverse effect of and underdosing of primarily systemic and hematological agents, not elsewhere classified (via D61.-), T46 — Poisoning by, adverse effect of and underdosing of agents primarily affecting the cardiovascular system (via D61.-), T47 — Poisoning by, adverse effect of and underdosing of agents primarily affecting the gastrointestinal system (via D61.-), T47-T50 — Hormones & Systemic Agents (T47-T50) (via D61.-), +3 more.
Each of these codes carries a Code First note naming this condition — when that code is reported, THIS code is sequenced first, ahead of it.
Contextual Map
Every relationship of D61.81 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.
Run D61.81 with these 16 related codes in Claim Check
Hierarchy
- D50-D89 — Chapter 3: Diseases of the Blood and Blood-forming Organs and Certain Disorders Involving the Immune Mechanism (D50-D89) (D50-D89)[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
Excludes1
- B20 — Human immunodeficiency virus [HIV] disease[Excludes1]: “pancytopenia (due to) (with) human immunodeficiency virus disease (B20.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- C91.4 — Hairy cell leukemia[Excludes1]: “pancytopenia (due to) (with) hairy cell leukemia (C91.4-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- D47.1 — Chronic myeloproliferative disease[Excludes1]: “pancytopenia (due to) (with) myeloproliferative disease (D47.1)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- D61.01 — Constitutional (pure) red blood cell aplasia[Excludes1]: “pancytopenia (due to) (with) congenital (pure) red cell aplasia (D61.01)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- D61.82 — Myelophthisis[Excludes1]: “pancytopenia (due to) (with) bone marrow infiltration (D61.82)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- D61.9 — Aplastic anemia, unspecified[Excludes1]: “pancytopenia (due to) (with) aplastic anemia (D61.9)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
Excludes2
- D46 — Myelodysplastic syndromes[Excludes2]: “pancytopenia (due to) (with) myelodysplastic syndromes (D46.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
Referenced by Excludes1 notes
- R71 — Abnormality of red blood cells[Excludes1](via D61.-): “anemias (D50-D64)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
Referenced by Code First instructions (23)
- I21.A1 — Myocardial infarction type 2[Code First](via D61.-): “anemia (D50.0-D64.9)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- M90.5 — Osteonecrosis in diseases classified elsewhere[Code First](via D61.-): “hemoglobinopathy (D50-D64)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- T36 — Poisoning by, adverse effect of and underdosing of systemic antibiotics[Code First](via D61.-): “blood disorders (D56-D76)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- T36-T39 — Antibiotics & Anti-infectives (T36-T39)[Code First](via D61.-): “blood disorders (D56-D76)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- T36-T50 — Poisoning by, adverse effects of and underdosing of drugs, medicaments and biological substances (T36-T50)[Code First](via D61.-): “blood disorders (D56-D76)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- T37 — Poisoning by, adverse effect of and underdosing of other systemic anti-infectives and antiparasitics[Code First](via D61.-): “blood disorders (D56-D76)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- T38 — Poisoning by, adverse effect of and underdosing of hormones and their synthetic substitutes and antagonists, not elsewhere classified[Code First](via D61.-): “blood disorders (D56-D76)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- T39 — Poisoning by, adverse effect of and underdosing of nonopioid analgesics, antipyretics and antirheumatics[Code First](via D61.-): “blood disorders (D56-D76)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- and 15 more
Nearest codes (16)
- D61 — Other aplastic anemias and other bone marrow failure syndromes[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- D61.0 — Constitutional aplastic anemia[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- D61.01 — Constitutional (pure) red blood cell aplasia[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- D61.02 — Shwachman-Diamond syndrome[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- D61.03 — Fanconi anemia[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- D61.09 — Other constitutional aplastic anemia[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- D61.1 — Drug-induced aplastic anemia[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- D61.2 — Aplastic anemia due to other external agents[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- and 8 more
Change history
- FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016
Common coding questions
Can D61.81 be billed directly?
No. D61.81 (Pancytopenia) is a non-billable ICD-10-CM category code. A more specific billable subcode must be selected based on clinical documentation.
Sources for this page
Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.
- Code, title, tabular notes and index terms Official source data
- CMS/CDC ICD-10-CM FY2026 tabular list, index and tables, effective October 1, 2025 Release, file and checksum · Publisher’s page
- Claim edits Official source data
- CMS Definitions of Medicare Code Edits — v43.1 (April 2026) Release, file and checksum · Publisher’s page
- Change history and date-of-service validity Official source data
- CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page
- Comparisons, relationships and the contextual map MedCoder structured relationship
- Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
- Summary and FAQ answers MedCoder explanation
- Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.
Labels on this page: Official source data · MedCoder structured relationship · MedCoder explanation. How to read the labels · All data sources and release dates
Cite this page
Reference this page in a research guide, syllabus or article. The release is included because code content changes each year.
MedCoder.ai. "D61.81 — Pancytopenia." ICD-10-CM FY2026. https://medcoder.ai/icd10/code/d61.81-pancytopenia
Change history
- FY2016 — October 1, 2015In the code set at ICD-10-CM adoptionPancytopenia
No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027 (effective October 1, 2026), and none are recorded for this code. Note changes are tracked from FY2027 only.
Nearest Codes in This Family
Official ICD-10-CM classifications closest to D61.81 in its code family, with their registry titles.
- D61.09 — Other constitutional aplastic anemia
- D61.1 — Drug-induced aplastic anemia
- D61.2 — Aplastic anemia due to other external agents
- D61.3 — Idiopathic aplastic anemia
- D61.8 — Other specified aplastic anemias and other bone marrow failure syndromes
- D61.810 — Antineoplastic chemotherapy induced pancytopenia
- D61.811 — Other drug-induced pancytopenia
- D61.818 — Other pancytopenia
- D61.82 — Myelophthisis
- D61.89 — Other specified aplastic anemias and other bone marrow failure syndromes