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ICD-10 Guide
ICD-10 CodesD61.2

D61.2

Billable

Aplastic anemia due to other external agents

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

Code Description

ICD-10 D61.2 is a billable code used to indicate a diagnosis of aplastic anemia due to other external agents.

Key Diagnostic Point:

Aplastic anemia is a rare but serious condition characterized by the failure of the bone marrow to produce sufficient blood cells, leading to pancytopenia (a reduction in red blood cells, white blood cells, and platelets). This specific code, D61.2, is used when aplastic anemia is attributed to external agents, which may include exposure to certain chemicals, drugs, radiation, or infections. The pathophysiology involves damage to hematopoietic stem cells in the bone marrow, resulting in inadequate hematopoiesis. Clinically, patients may present with symptoms such as fatigue, increased susceptibility to infections, and bleeding tendencies due to low platelet counts. Diagnosis typically involves blood tests showing low cell counts and a bone marrow biopsy revealing hypocellularity. Treatment options may include immunosuppressive therapy, bone marrow transplantation, or supportive care, depending on the severity and underlying cause of the condition.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between aplastic anemia and other forms of anemia.
  • Identifying the specific external agent responsible for the condition.
  • Understanding the patient's medical history and potential exposures.
  • Navigating the documentation requirements for external agent attribution.

Audit Risk Factors

  • Inadequate documentation of external agent exposure.
  • Failure to specify the type of aplastic anemia.
  • Misclassification of anemia type.
  • Lack of supporting lab results or biopsy findings.

Specialty Focus

Medical Specialties

Hematology

Documentation Requirements

Detailed patient history, exposure history, lab results, and treatment plans.

Common Clinical Scenarios

Patients presenting with unexplained anemia, requiring further investigation into potential external causes.

Billing Considerations

Ensure thorough documentation of all potential exposures and treatments to support the diagnosis.

Oncology

Documentation Requirements

Comprehensive cancer treatment history, including chemotherapy or radiation exposure.

Common Clinical Scenarios

Patients with a history of cancer treatment presenting with symptoms of anemia.

Billing Considerations

Document any prior treatments that could contribute to bone marrow suppression.

Coding Guidelines

Inclusion Criteria

Use D61.2 When
  • Follow ICD
  • CM guidelines for coding aplastic anemia, ensuring to document the external agent when applicable
  • Include any relevant lab results and patient history to support the diagnosis

Exclusion Criteria

Do NOT use D61.2 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

85025CPT Code

Complete blood count (CBC) with differential

Clinical Scenario

Used to evaluate blood cell counts in suspected aplastic anemia.

Documentation Requirements

Document the reason for the CBC and any relevant symptoms.

Specialty Considerations

Hematologists should ensure all relevant lab results are included in the patient's record.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of aplastic anemia, including the identification of external agents. This specificity aids in better tracking of causes and outcomes, improving patient care and research.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of aplastic anemia, including the identification of external agents. This specificity aids in better tracking of causes and outcomes, improving patient care and research.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of aplastic anemia, including the identification of external agents. This specificity aids in better tracking of causes and outcomes, improving patient care and research.

Resources

Clinical References

  • •
    American Society of Hematology

Coding & Billing References

  • •
    American Society of Hematology

Frequently Asked Questions

What are the common causes of aplastic anemia?

Common causes include exposure to chemicals (like benzene), certain medications, radiation, and viral infections. Identifying the specific cause is crucial for appropriate management.