D81 ICD-10-CM Code: Combined immunodeficiencies
Compare with another code for D81Check this code on a claim
Billing Status: NO. This is a non-billable ICD-10-CM code: report a more specific billable code beneath it.
Coding at a Glance
- Official instructions
- 3 inclusion terms · 3 Excludes1 · 1 Excludes2
Category · FY2027A non-billable heading in the tabular list: report a more specific code beneath it.
What you need to know
Source: CMS/NCHS Official ICD-10-CM tabular notes, quoted. From the CMS/NCHS tabular list for the release in force. A note the category or block publishes applies to this code too, and is marked with where it comes from.
- Excludes1Not reported with this code unless documented as unrelated
- Excludes2from D80-D89Not included here; may be reported together
- human immunodeficiency virus [HIV] disease (B20)
- Includesfrom D80-D89What D80-D89 covers
- defects in the complement system
- immunodeficiency disorders, except human immunodeficiency virus [HIV] disease
- sarcoidosis
Where it sits Source: CMS/NCHS
Under:Chapter 3: Diseases of the Blood and Blood-forming Organs and Certain Disorders Involving the Immune MechanismD80-D89 Certain disorders involving the immune mechanism
Codes under D81 (10)
- D81.0Severe combined immunodeficiency [SCID] with reticular dysgenesisBillable
- D81.1Severe combined immunodeficiency [SCID] with low T- and B-cell numbersBillable
- D81.2Severe combined immunodeficiency [SCID] with low or normal B-cell numbersBillable
- D81.3Adenosine deaminase [ADA] deficiencyNot billable
- D81.4Nezelof's syndromeBillable
- D81.5Purine nucleoside phosphorylase [PNP] deficiencyBillable
- D81.6Major histocompatibility complex class I deficiencyBillable
- D81.7Major histocompatibility complex class II deficiencyBillable
- D81.8Other combined immunodeficienciesNot billable
- D81.9Combined immunodeficiency, unspecifiedBillable
Most relevant related codes MedCoder-derived
Read off the official notes above and this code’s own position in the tabular list. Which to report is a documentation question; Compare shows the two side by side.
Coding instructions
Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for D81 in the official ICD-10-CM tabular list, quoted as published.
Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2027Effective: October 1, 2026
Trace:FY2027 changesChange historyRelease, file and checksum
Notes without a marker are published on D81 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.
- defects in the complement system
- immunodeficiency disorders, except human immunodeficiency virus [HIV] disease
- sarcoidosis
Source: inherited from D80-D89
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).
- autosomal recessive agammaglobulinemia (Swiss type) (D80.0) Compare D81 vs D80.0 →
- autoimmune disease (systemic) NOS (M35.9) inherited from D80-D89Compare D81 vs M35.9 →
- functional disorders of polymorphonuclear neutrophils (D71-) inherited from D80-D89Compare D81 vs D71 →
Excludes2 — Not Included Here
Conditions not covered by this code, but which may be reported alongside it when both are present.
- human immunodeficiency virus [HIV] disease (B20) Compare D81 vs B20 →
Source: inherited from D80-D89
Coder workflow for D81
MedCoder structured workflow — derived from this code’s own official record
Before you code D81
- D81 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).
ReviewD81.0, D81.1, D81.2, D81.3, D81.4, D81.5, D81.6, D81.7, D81.8, D81.9
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 the code beneath D81. 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 D81?
Yes → Select that code and continue the checks below on its own page.
No → D81 cannot be reported as written. Where the codes beneath it include an unspecified code, that code applies when the record goes no further; otherwise query for the missing detail.ReviewD81.0, D81.1, D81.2, D81.3, D81.4, D81.5, D81.6, D81.7, D81.8, D81.9
- Does the documentation support a condition named in D81’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.
Report the code beneath D81 that the documentation supports, not D81 itself. Then confirm that code is valid for the date of service on its own page.
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 D81(3 notes)
Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with D81: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.
See the official tabular notes · Guidelines I.A.12.a
Excludes2 — not part of D81(1 note)
Coding workflow: The conditions named in this note are not included in D81. When the record documents both, both may be reported; the note is a boundary, not a prohibition.
CompareB20
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 D81 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.
Coding context
Guidelines, coding notes, decision aids, relationships (with MS-DRG and CCSR classification), hierarchy, HCC, coverage and the context map: what a coder reaches for after the core. Each section names whether it is official source data, a MedCoder-derived relationship or MedCoder editorial.
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-derived relationships — computed from published CMS and AHRQ datasets
Other codes that name D81 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 3 Excludes1 notes across 2 chapters: D72 — Other disorders of white blood cells, D84.81 — Immunodeficiency due to conditions classified elsewhere, E79 — Disorders of purine and pyrimidine metabolism.
These codes’ tabular lists mark this diagnosis as mutually exclusive — not reported together unless the conditions are documented as unrelated.
Contextual Map
Every relationship of D81 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 D81 with these 7 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-fy2027
- D80-D89 — Certain disorders involving the immune mechanism[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2027
Excludes1
- D71 — Functional disorders of polymorphonuclear neutrophils[Excludes1]: “functional disorders of polymorphonuclear neutrophils (D71-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2027
- D80.0 — Hereditary hypogammaglobulinemia[Excludes1]: “autosomal recessive agammaglobulinemia (Swiss type) (D80.0)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2027
- M35.9 — Systemic involvement of connective tissue, unspecified[Excludes1]: “autoimmune disease (systemic) NOS (M35.9)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2027
Excludes2
- B20 — Human immunodeficiency virus [HIV] disease[Excludes2]: “human immunodeficiency virus [HIV] disease (B20)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2027
Referenced by Excludes1 notes
- D72 — Other disorders of white blood cells[Excludes1]: “immunity disorders (D80-D89)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2027
- D84.81 — Immunodeficiency due to conditions classified elsewhere[Excludes1]: “certain disorders involving the immune mechanism (D80-D83, D84.0, D84.1, D84.9)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2027
- E79 — Disorders of purine and pyrimidine metabolism[Excludes1]: “combined immunodeficiency disorders (D81.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2027
Nearest codes (20)
- D81.0 — Severe combined immunodeficiency [SCID] with reticular dysgenesis[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2027
- D81.1 — Severe combined immunodeficiency [SCID] with low T- and B-cell numbers[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2027
- D81.2 — Severe combined immunodeficiency [SCID] with low or normal B-cell numbers[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2027
- D81.3 — Adenosine deaminase [ADA] deficiency[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2027
- D81.30 — Adenosine deaminase deficiency, unspecified[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2027
- D81.31 — Severe combined immunodeficiency due to adenosine deaminase deficiency[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2027
- D81.32 — Adenosine deaminase 2 deficiency[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2027
- D81.39 — Other adenosine deaminase deficiency[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2027
- and 12 more
Change history (3)
- FY2027 — Excludes2 note added[Change history]— CMS release files (code change ledger) · icd10cm-fy2027
- and 2 more
Reference
Index terms and tables, published questions and FAQ, every source behind this page with its release and checksum, the date-of-service check and the complete change history.
Common coding questions
MedCoder editorial
Can D81 be billed directly?
No. D81 (Combined immunodeficiencies) 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 FY2027 tabular list, index and tables, effective October 1, 2026 Release, file and checksum · Publisher’s page
- Claim edits Official source data
- CMS Definitions of Medicare Code Edits — v44.0 (October 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-derived 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 editorial 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.
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
Labels on this page: Official source data · MedCoder-derived relationship · MedCoder editorial explanation. How to read the labels · All data sources and release dates · CMS coding rules
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. "D81 — Combined immunodeficiencies." ICD-10-CM FY2027. https://medcoder.ai/icd10/code/d81-combined-immunodeficiencies
Change history
Changed in FY2027, the release in force: Excludes2 note added; Excludes1 note removed.
- FY2027 — October 1, 2026Excludes2 note addedhuman immunodeficiency virus [HIV] disease (B20)FY2027 changes
- FY2027 — October 1, 2026Excludes1 note removedhuman immunodeficiency virus [HIV] disease (B20)FY2027 changes
- FY2016 — October 1, 2015In the code set at ICD-10-CM adoptionCombined immunodeficiencies
Nearest Codes in This Family
Official ICD-10-CM classifications closest to D81 in its code family, with their registry titles.
- D81.0 — Severe combined immunodeficiency [SCID] with reticular dysgenesis
- D81.1 — Severe combined immunodeficiency [SCID] with low T- and B-cell numbers
- D81.2 — Severe combined immunodeficiency [SCID] with low or normal B-cell numbers
- D81.3 — Adenosine deaminase [ADA] deficiency
- D81.30 — Adenosine deaminase deficiency, unspecified
- D81.31 — Severe combined immunodeficiency due to adenosine deaminase deficiency
- D81.32 — Adenosine deaminase 2 deficiency
- D81.39 — Other adenosine deaminase deficiency
- D81.4 — Nezelof's syndrome
- D81.5 — Purine nucleoside phosphorylase [PNP] deficiency
- D81.6 — Major histocompatibility complex class I deficiency
- D81.7 — Major histocompatibility complex class II deficiency
- D81.8 — Other combined immunodeficiencies
- D81.81 — Biotin-dependent carboxylase deficiency
- D81.810 — Biotinidase deficiency
- D81.818 — Other biotin-dependent carboxylase deficiency
- D81.819 — Biotin-dependent carboxylase deficiency, unspecified
- D81.82 — Activated Phosphoinositide 3-kinase Delta Syndrome [APDS]
- D81.89 — Other combined immunodeficiencies
- D81.9 — Combined immunodeficiency, unspecified