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ICD-10 Guide
ICD-10 CodesD61.810

D61.810

Billable

Antineoplastic chemotherapy induced pancytopenia

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

Code Description

ICD-10 D61.810 is a billable code used to indicate a diagnosis of antineoplastic chemotherapy induced pancytopenia.

Key Diagnostic Point:

Antineoplastic chemotherapy induced pancytopenia is a hematological condition characterized by a reduction in red blood cells, white blood cells, and platelets due to the effects of chemotherapy agents used in cancer treatment. This condition arises when chemotherapy damages the bone marrow, leading to impaired hematopoiesis, which is the process of blood cell production. Patients may present with symptoms such as fatigue, increased susceptibility to infections, and bleeding tendencies due to low platelet counts. The severity of pancytopenia can vary based on the type and dosage of chemotherapy, as well as the patient's overall health and pre-existing conditions. Aplastic anemia, a form of bone marrow failure, can also be a consequence of chemotherapy, where the bone marrow fails to produce adequate blood cells. Acquired anemias, including those induced by antineoplastic agents, require careful monitoring and management, as they can significantly impact treatment plans and patient outcomes. Understanding the pathophysiology and clinical implications of chemotherapy-induced pancytopenia is crucial for effective management and coding.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between chemotherapy-induced pancytopenia and other forms of anemia or bone marrow failure.
  • Understanding the specific chemotherapy agents that can lead to this condition.
  • Documenting the severity and duration of pancytopenia accurately.
  • Co-existing conditions that may complicate the diagnosis.

Audit Risk Factors

  • Inadequate documentation of chemotherapy history.
  • Failure to specify the severity of pancytopenia.
  • Misclassification of the type of anemia.
  • Lack of supporting lab results for blood counts.

Specialty Focus

Medical Specialties

Hematology/Oncology

Documentation Requirements

Detailed records of chemotherapy regimens, lab results, and patient symptoms.

Common Clinical Scenarios

Patients undergoing chemotherapy who present with fatigue, infections, or bleeding.

Billing Considerations

Close monitoring of blood counts and timely documentation of any changes in the patient's condition.

Internal Medicine

Documentation Requirements

Comprehensive patient history, including previous treatments and current symptoms.

Common Clinical Scenarios

Management of patients with multiple comorbidities and complications from chemotherapy.

Billing Considerations

Understanding the interplay between chemotherapy effects and other medical conditions.

Coding Guidelines

Inclusion Criteria

Use D61.810 When
  • According to ICD
  • 10 guidelines, D61
  • 810 should be used when pancytopenia is specifically attributed to antineoplastic chemotherapy
  • Coders must ensure that the documentation supports the diagnosis and that other potential causes of pancytopenia are ruled out

Exclusion Criteria

Do NOT use D61.810 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

85025CPT Code

Complete blood count (CBC) with differential

Clinical Scenario

Used to monitor blood counts in patients undergoing chemotherapy.

Documentation Requirements

Document the reason for the CBC and any relevant symptoms.

Specialty Considerations

Hematology specialists should ensure that the CBC results are correlated with clinical findings.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of conditions like D61.810, improving the accuracy of patient records and facilitating better management of chemotherapy-related complications.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like D61.810, improving the accuracy of patient records and facilitating better management of chemotherapy-related complications.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of conditions like D61.810, improving the accuracy of patient records and facilitating better management of chemotherapy-related complications.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What is the primary cause of D61.810?

D61.810 is primarily caused by the effects of antineoplastic chemotherapy on bone marrow, leading to reduced production of blood cells.

How can coders ensure accurate coding for D61.810?

Coders should ensure that documentation clearly links the diagnosis of pancytopenia to chemotherapy treatment and includes relevant lab results.