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ICD-10 Guide
ICD-10 CodesChapter 3: Diseases of the blood and blood-forming organsD81

D81

Billable

Combined immunodeficiencies

Chapter 3:Diseases of the blood and blood-forming organs

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/05/2025

Code Description

ICD-10 D81 is a billable code used to indicate a diagnosis of combined immunodeficiencies.

Key Diagnostic Point:

Combined immunodeficiencies (D81) refer to a group of disorders characterized by the simultaneous impairment of both humoral and cellular immunity. These conditions can lead to increased susceptibility to infections, autoimmune diseases, and malignancies. The immunodeficiencies can be congenital or acquired, with congenital forms often resulting from genetic mutations affecting immune system development. Patients may present with recurrent infections, failure to thrive, and other systemic complications. Diagnosis typically involves immunological assessments, including serum immunoglobulin levels, lymphocyte counts, and functional assays to evaluate immune response. Management may include immunoglobulin replacement therapy, prophylactic antibiotics, and in some cases, hematopoietic stem cell transplantation. The complexity of these disorders necessitates a multidisciplinary approach involving immunologists, hematologists, and other specialists to ensure comprehensive care and management of associated complications.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Variety of underlying genetic causes
  • Need for comprehensive immunological testing
  • Potential for overlapping symptoms with other disorders
  • Management may involve multiple specialties

Audit Risk Factors

  • Inadequate documentation of recurrent infections
  • Failure to specify the type of combined immunodeficiency
  • Lack of evidence for immunological testing results
  • Insufficient detail on treatment plans and responses

Specialty Focus

Medical Specialties

Immunology

Documentation Requirements

Detailed immunological assessment results, including immunoglobulin levels and lymphocyte subsets.

Common Clinical Scenarios

Patients presenting with recurrent infections, failure to thrive, or autoimmune manifestations.

Billing Considerations

Ensure all immunological tests are documented and correlate with clinical findings.

Hematology

Documentation Requirements

Complete blood counts, bone marrow biopsy results, and any relevant genetic testing.

Common Clinical Scenarios

Patients with hematological manifestations of immunodeficiency, such as lymphopenia or cytopenias.

Billing Considerations

Document any hematological complications and their management thoroughly.

Coding Guidelines

Inclusion Criteria

Use D81 When
  • Follow official ICD
  • CM coding guidelines, ensuring accurate documentation of the condition's severity and any associated complications
  • Include relevant laboratory results and treatment plans

Exclusion Criteria

Do NOT use D81 When
No specific exclusions found.

Related CPT Codes

36415CPT Code

Collection of venous blood by venipuncture

Clinical Scenario

Used for obtaining blood samples for immunological testing.

Documentation Requirements

Document the reason for blood collection and any relevant patient history.

Specialty Considerations

Ensure that the specialty performing the test is clearly indicated.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of immunodeficiencies, enabling better tracking of these conditions and their management. This specificity aids in research and improves patient care by ensuring appropriate treatment protocols are followed.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of immunodeficiencies, enabling better tracking of these conditions and their management. This specificity aids in research and improves patient care by ensuring appropriate treatment protocols are followed.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of immunodeficiencies, enabling better tracking of these conditions and their management. This specificity aids in research and improves patient care by ensuring appropriate treatment protocols are followed.

Resources

Clinical References

  • •
    American Academy of Allergy, Asthma & Immunology

Coding & Billing References

  • •
    American Academy of Allergy, Asthma & Immunology

Frequently Asked Questions

What are the common symptoms of combined immunodeficiencies?

Common symptoms include recurrent infections, failure to thrive, autoimmune disorders, and increased susceptibility to certain cancers. Patients may experience frequent respiratory infections, gastrointestinal infections, and skin infections.