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D70.4 ICD-10-CM Code: Cyclic neutropenia

Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Coding at a Glance

Tabular directives
4 inclusion terms · 2 Excludes1 · 2 use-additional codes · 1 code-also instruction
Risk adjustment
CMS-HCC V28: 1 category · CMS-HCC V22 category 47

Inpatient Payment Groups (MS-DRG)

Potential MS-DRG participation — not a DRG assignment.

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v43, Appendix B.

  • MS-DRG 808 — MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH MCC (MDC 16)
  • MS-DRG 809 — MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH CC (MDC 16)
  • MS-DRG 810 — MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITHOUT CC/MCC (MDC 16)

A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.

Risk Adjustment (CMS-HCC)

Payment categories this diagnosis maps to under CMS-HCC V28, payment year 2026.

  • HCC 115 — Specified Immunodeficiencies and White Blood Cell Disorders

Other models: CMS-HCC V22 HCC 47

Risk scores depend on the enrollee's full accepted diagnosis set and segment; a category mapping alone does not determine payment.

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for D70.4 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 D70.4 itself; “inherited from” names the category or block whose note applies here.

Includes

Conditions the official ICD-10-CM tabular list includes under this code.

  • agranulocytosis
  • decreased absolute neurophile count (ANC)

Source: inherited from D70

Inclusion Terms

Alternative terms the tabular list files under this code.

  • Cyclic hematopoiesis
  • Periodic neutropenia

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).

Source: inherited from D70

Code Also

Additional codes that may be required to fully describe the encounter.

Source: inherited from D70

Use Additional Code

Supplementary codes the tabular list directs you to add.

  • Use additional code for any associated:
  • fever (R50.81)

Source: inherited from D70

Coder workflow for D70.4

MedCoder structured workflow — derived from this code’s own official record

Before you code D70.4

  1. Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with D70.4. Excludes1 conditions are not reported together with this code unless the record shows they are unrelated (Guidelines I.A.12.a).

    See the official tabular notes

Choose the right path

  1. Does the documentation support a condition named in D70.4’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.

    ReviewD73.81, P61.5

Consider D70.4. Then work the Use Additional Code note and review the Code Also note, and 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).
The conditions the Use Additional Code note names
Reported with this code when documented; a conditional instruction (“if applicable”, “if known”) applies only when the record supports it.

Official instructions as workflow

  • Excludes1 — check before selecting D70.4(2 notes)

    Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with D70.4: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.

    CompareD73.81, P61.5

    See the official tabular notes · Guidelines I.A.12.a

  • Use Additional Code — after identifying D70.4(2 notes)

    Coding workflow: Check whether the documentation supports the additional code(s) the note names, and report them with D70.4 when it does. Where the instruction is conditional (“if applicable”, “if known”), it applies only when the record documents the condition.

    ReviewR50.81

    See the official tabular notes · Guidelines I.A.13

  • Code Also — related condition(1 note)

    Coding workflow: Review the related condition when both are documented and the instruction applies. A Code Also note does not fix sequencing; the order follows the circumstances of the encounter.

    ReviewJ34.81, K12.3, K92.81, N76.81

    See the official tabular notes · Guidelines I.A.17

Coding decision scenarios

Pattern scenarios for this code’s structure — decision rules, not clinical cases

Documentation: Both the condition D70.4 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).

ReviewD73.81, P61.5

Documentation: A condition the Use Additional Code note names is documented.

Coding question: Is a second code reported with D70.4?

Path: Review the Use Additional Code note and the code it names.

Reason: The additional code is reported when the record documents the condition; a conditional instruction applies only when its condition is met (Guidelines I.A.13).

ReviewR50.81

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

Cyclic neutropenia is a billable ICD-10-CM diagnosis code (D70.4).

MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.

Indexed Clinical Terms (5)

Official source data — entries quoted as published, in the Index’s own lookup phrasing

Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code. These are alphabetic-index entries shown as the Index writes them — lookup phrasing, not necessarily the wording of a final diagnosis.

Official Coding Guidelines

No excerpt in the ICD-10-CM Official Guidelines names this code specifically. Its chapter carries only this chapter-wide note:

Chapter 3: Disease of the blood and blood-forming organs and certain disorders involving the immune mechanism (D50-D89)

Reserved for future guideline expansion

Decision Points

The directives on this code's own record, as a pre-claim checklist.

  1. 2 Use Additional Code instructions — report the named additional code(s) when the documentation supports them. See the Use Additional Code notes
  2. 1 Code Also note — a second code may apply; the guidelines leave its sequencing to the circumstances of the encounter. See the Code Also notes
  3. 2 Excludes1 entries — codes named there are generally not reported together with this code (Guidelines I.A.12.a). See the Excludes1 notes

Checklist rows are derived from this code's own official directives; the wording of each check is MedCoder editorial. The official notes themselves are in the sections each row links to.

Verify Before Coding

  • No Medicare Code Editor or MS-DRG Definitions Manual restrictions apply to this code.

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 D70.4 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 11 Excludes2 notes across 2 chapters: D61 — Other aplastic anemias and other bone marrow failure syndromes (via D70.-), R70 — Elevated erythrocyte sedimentation rate and abnormality of plasma viscosity (via D70.-), R70-R79 — Abnormal findings on examination of blood, without diagnosis (R70-R79) (via D70.-), R71 — Abnormality of red blood cells (via D70.-), R73 — Elevated blood glucose level (via D70.-), R74 — Abnormal serum enzyme levels (via D70.-), R75 — Inconclusive laboratory evidence of human immunodeficiency virus [HIV] (via D70.-), R76 — Other abnormal immunological findings in serum (via D70.-), R77 — Other abnormalities of plasma proteins (via D70.-), R78 — Findings of drugs and other substances, not normally found in blood (via D70.-), R79 — Other abnormal findings of blood chemistry (via D70.-).

These codes’ tabular lists name this diagnosis as distinct — both may be reported when both are documented.

Referenced by 22 Code First instructions across 2 chapters: R50.81 — Fever presenting with conditions classified elsewhere (via D70.-), T36 — Poisoning by, adverse effect of and underdosing of systemic antibiotics (via D70.-), T36-T39 — Antibiotics & Anti-infectives (T36-T39) (via D70.-), T36-T50 — Poisoning by, adverse effects of and underdosing of drugs, medicaments and biological substances (T36-T50) (via D70.-), T37 — Poisoning by, adverse effect of and underdosing of other systemic anti-infectives and antiparasitics (via D70.-), T38 — Poisoning by, adverse effect of and underdosing of hormones and their synthetic substitutes and antagonists, not elsewhere classified (via D70.-), T39 — Poisoning by, adverse effect of and underdosing of nonopioid analgesics, antipyretics and antirheumatics (via D70.-), T40 — Poisoning by, adverse effect of and underdosing of narcotics and psychodysleptics [hallucinogens] (via D70.-), T40-T41 — Analgesics & Antipyretics (T40-T41) (via D70.-), T41 — Poisoning by, adverse effect of and underdosing of anesthetics and therapeutic gases (via D70.-), T42 — Poisoning by, adverse effect of and underdosing of antiepileptic, sedative- hypnotic and antiparkinsonism drugs (via D70.-), T42-T43 — Anticonvulsants & Psychotropics (T42-T43) (via D70.-), T43 — Poisoning by, adverse effect of and underdosing of psychotropic drugs, not elsewhere classified (via D70.-), T44 — Poisoning by, adverse effect of and underdosing of drugs primarily affecting the autonomic nervous system (via D70.-), T44-T46 — Cardiovascular & Gastrointestinal (T44-T46) (via D70.-), T45 — Poisoning by, adverse effect of and underdosing of primarily systemic and hematological agents, not elsewhere classified (via D70.-), T46 — Poisoning by, adverse effect of and underdosing of agents primarily affecting the cardiovascular system (via D70.-), T47 — Poisoning by, adverse effect of and underdosing of agents primarily affecting the gastrointestinal system (via D70.-), T47-T50 — Hormones & Systemic Agents (T47-T50) (via D70.-), T48 — Poisoning by, adverse effect of and underdosing of agents primarily acting on smooth and skeletal muscles and the respiratory system (via D70.-), +2 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.

MS-DRG Grouper Relationships (FY2026)

Potential MS-DRG participation — not a DRG assignment.

FY2026 MS-DRG: not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity for that release.

Named in the grouper logic of 3 MS-DRGs: DRG 808 (MDC 16), DRG 809 (MDC 16), DRG 810 (MDC 16).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Clinical classification (AHRQ CCSR):BLD007 — Diseases of white blood cells (default).

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Related Codes

Same CMS-HCC risk category (V28)

CMS maps these diagnoses to the same Hierarchical Condition Category (Specified Immunodeficiencies and White Blood Cell Disorders) for risk-adjusted payment.

D70.0 — Congenital agranulocytosis, D71 — Functional disorders of polymorphonuclear neutrophils, D71.1 — Leukocyte adhesion deficiency, D71.8 — Other functional disorders of polymorphonuclear neutrophils, D71.9 — Functional disorders of polymorphonuclear neutrophils, unspecified, D72.0 — Genetic anomalies of leukocytes, D76.1 — Hemophagocytic lymphohistiocytosis, D76.3 — Other histiocytosis syndromes, D80.0 — Hereditary hypogammaglobulinemia, D80.2 — Selective deficiency of immunoglobulin A [IgA], D80.3 — Selective deficiency of immunoglobulin G [IgG] subclasses, D80.4 — Selective deficiency of immunoglobulin M [IgM], D80.5 — Immunodeficiency with increased immunoglobulin M [IgM], D81.4 — Nezelof's syndrome, D82.0 — Wiskott-Aldrich syndrome, D82.1 — Di George's syndrome, D84.1 — Defects in the complement system, D89.84 — IgG4-related disease

Related risk categories

These categories interact through CMS's HCC hierarchy — one can suppress the other's risk-adjustment weight when both are present on a claim.

Common Variable and Combined Immunodeficiencies

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Diseases of white blood cells).

D70.0 — Congenital agranulocytosis, D70.1 — Agranulocytosis secondary to cancer chemotherapy, D70.2 — Other drug-induced agranulocytosis, D70.3 — Neutropenia due to infection, D70.8 — Other neutropenia, D70.9 — Neutropenia, unspecified, D71 — Functional disorders of polymorphonuclear neutrophils, D71.1 — Leukocyte adhesion deficiency, D71.8 — Other functional disorders of polymorphonuclear neutrophils, D71.9 — Functional disorders of polymorphonuclear neutrophils, unspecified, D72.0 — Genetic anomalies of leukocytes, D72.1 — Eosinophilia, D72.10 — Eosinophilia, unspecified, D72.110 — Idiopathic hypereosinophilic syndrome [IHES], D72.111 — Lymphocytic Variant Hypereosinophilic Syndrome [LHES], D72.118 — Other hypereosinophilic syndrome, D72.119 — Hypereosinophilic syndrome [HES], unspecified, D72.12 — Drug rash with eosinophilia and systemic symptoms syndrome, D72.18 — Eosinophilia in diseases classified elsewhere, D72.19 — Other eosinophilia, +17 more

Same Index main term, other category

The ICD-10-CM Index to Diseases and Injuries files this code under the main term “Neutropenia, neutropenic”; these codes share that main term but sit in a different category of the Tabular List.

P61.5 — Transient neonatal neutropenia

Lab tests where this diagnosis supports Medicare coverage (NCD)

Medicare's National Coverage Determination (NCD) program lists this diagnosis as medical justification for these lab tests.

HIV Screening Test

Contextual Map

Every relationship of D70.4 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 D70.4 with these 16 related codes in Claim Check

Hierarchy

Referenced by Excludes2 notes (11)

Referenced by Code First instructions (22)

Clinical classification (CCSR)

Risk adjustment (CMS-HCC)

  • HCC 115 — Specified Immunodeficiencies and White Blood Cell Disorders [CMS-HCC]— CMS-HCC V28 · 2026

MS-DRG Grouper

MDC crossing

  • MDC 16 — Diseases and Disorders of Blood, Blood Forming Organs and Immunologic Disorders[MDC crossing]: “Diseases and Disorders of Blood, Blood Forming Organs and Immunologic Disorders — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs. 1,614 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2026

Index entries

  • Agranulocytosis (chronic) (cyclical) (genetic) (infantile) (periodic) (pernicious), secondary[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Hematopoiesis, cyclic[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Neutropenia, neutropenic (chronic) (genetic) (idiopathic) (immune) (infantile) (malignant) (pernicious) (splenic), cyclic[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Neutropenia, neutropenic (chronic) (genetic) (idiopathic) (immune) (infantile) (malignant) (pernicious) (splenic), periodic[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Neutropenia, neutropenic (chronic) (genetic) (idiopathic) (immune) (infantile) (malignant) (pernicious) (splenic), secondary (cyclic) (periodic) (splenic)[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026

Nearest codes

Change history

  • FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016

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
Coding guidelines Official source data
ICD-10-CM Official Guidelines for Coding and Reporting (FY2026), quoted by section 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
Inpatient payment groups Official source data
CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v43 Release, file and checksum · Publisher’s page
Risk adjustment Official source data
2026 Mid-Year Final ICD-10 Mappings + Model Software (cms.gov/files/zip/2026-midyear-final-icd-10-mappings.zip, 2026-midyear-final-model-software.zip) — CMS-HCC V28, PY2026 mid-year final release 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. "D70.4 — Cyclic neutropenia." ICD-10-CM FY2026. https://medcoder.ai/icd10/code/d70.4-cyclic-neutropenia

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Cyclic neutropenia

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 D70.4 in its code family, with their registry titles.

View all codes in the D70 family