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ICD-10 Guide
ICD-10 CodesD61.89

D61.89

Billable

Other specified aplastic anemias and other bone marrow failure syndromes

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

Code Description

ICD-10 D61.89 is a billable code used to indicate a diagnosis of other specified aplastic anemias and other bone marrow failure syndromes.

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 condition can be acquired through various factors such as exposure to toxins, certain medications, viral infections, or autoimmune diseases. Other bone marrow failure syndromes may include conditions like myelodysplastic syndromes or inherited disorders such as Fanconi anemia. The clinical presentation often includes symptoms of anemia (fatigue, pallor), increased susceptibility to infections (due to low white blood cell counts), and bleeding tendencies (due to low platelet counts). Diagnosis typically involves blood tests, bone marrow biopsy, and exclusion of other causes of bone marrow failure. Management may include immunosuppressive therapy, blood transfusions, or hematopoietic stem cell transplantation, depending on the underlying cause and severity of the condition.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of underlying causes leading to aplastic anemia and bone marrow failure.
  • Need for comprehensive documentation to establish the specific type of anemia.
  • Differentiation from other hematological disorders.
  • Potential for overlapping symptoms with other conditions.

Audit Risk Factors

  • Insufficient documentation of the underlying cause of anemia.
  • Inconsistent coding of related conditions.
  • Failure to document the severity of the condition.
  • Lack of clarity in treatment plans.

Specialty Focus

Medical Specialties

Hematology

Documentation Requirements

Detailed patient history, laboratory results, and treatment plans.

Common Clinical Scenarios

Diagnosis and management of patients with unexplained anemia or bone marrow failure.

Billing Considerations

Ensure accurate coding of the specific type of anemia and any associated conditions.

Oncology

Documentation Requirements

Comprehensive oncology reports, treatment history, and follow-up care notes.

Common Clinical Scenarios

Management of patients with bone marrow failure syndromes secondary to malignancies or chemotherapy.

Billing Considerations

Document any malignancies that may contribute to bone marrow failure.

Coding Guidelines

Inclusion Criteria

Use D61.89 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the code is used only when the specific type of aplastic anemia or bone marrow failure syndrome is documented

Exclusion Criteria

Do NOT use D61.89 When
  • Exclude conditions that are not specified under this code

Related ICD-10 Codes

Related CPT Codes

85025CPT Code

Complete blood count (CBC) with differential

Clinical Scenario

Used to evaluate the severity of anemia in patients suspected of having aplastic anemia.

Documentation Requirements

Document the reason for the CBC and any relevant clinical findings.

Specialty Considerations

Hematologists should ensure that the CBC results are clearly linked to the diagnosis.

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 and related conditions, improving the accuracy of data collection and reimbursement processes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of aplastic anemia and related conditions, improving the accuracy of data collection and reimbursement processes.

Reimbursement & Billing Impact

reimbursement processes.

Resources

Clinical References

  • •
    American Society of Hematology

Coding & Billing References

  • •
    American Society of Hematology

Frequently Asked Questions

What is the difference between aplastic anemia and other types of anemia?

Aplastic anemia is specifically due to bone marrow failure, leading to a decrease in all blood cell types, while other types of anemia, such as iron deficiency anemia, are due to specific deficiencies or other underlying conditions.