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ICD-10 Guide
ICD-10 CodesD81.2

D81.2

Billable

Severe combined immunodeficiency [SCID] with low or normal B-cell numbers

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

Code Description

ICD-10 D81.2 is a billable code used to indicate a diagnosis of severe combined immunodeficiency [scid] with low or normal b-cell numbers.

Key Diagnostic Point:

Severe combined immunodeficiency (SCID) is a rare genetic disorder characterized by a profound defect in both T-lymphocyte and B-lymphocyte systems, leading to a severely compromised immune response. In cases classified under D81.2, patients exhibit low or normal B-cell numbers, which can complicate the clinical picture. SCID is often diagnosed in infancy, with affected individuals presenting with recurrent infections, failure to thrive, and other complications due to their inability to mount effective immune responses. The underlying genetic mutations can vary, and the condition may be inherited in an X-linked or autosomal recessive manner. Management typically involves supportive care, such as prophylactic antibiotics and immunoglobulin replacement therapy, and definitive treatment options like hematopoietic stem cell transplantation. Early diagnosis and intervention are crucial to improve outcomes and reduce morbidity associated with infections.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Variability in clinical presentation and genetic mutations
  • Need for comprehensive patient history and laboratory results
  • Differentiation from other immunodeficiencies
  • Potential for associated complications requiring additional coding

Audit Risk Factors

  • Inadequate documentation of B-cell counts
  • Failure to specify the type of SCID
  • Lack of supporting evidence for recurrent infections
  • Misclassification of related immunodeficiency disorders

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Detailed immunological assessments, family history, and infection history.

Common Clinical Scenarios

Infants presenting with recurrent infections, failure to thrive, and abnormal laboratory findings.

Billing Considerations

Documentation must clearly outline the immunodeficiency type and any genetic testing results.

Immunology

Documentation Requirements

Comprehensive immunological profiles, including T-cell and B-cell counts, and genetic testing results.

Common Clinical Scenarios

Patients undergoing evaluation for primary immunodeficiencies with abnormal immune function tests.

Billing Considerations

Accurate coding requires correlation of clinical findings with laboratory results.

Coding Guidelines

Inclusion Criteria

Use D81.2 When
  • Follow the official ICD
  • CM coding guidelines for coding immunodeficiencies
  • Ensure accurate documentation of B
  • cell counts and associated clinical findings
  • existing

Exclusion Criteria

Do NOT use D81.2 When
  • Exclude other immunodeficiency disorders unless co

Related ICD-10 Codes

Related CPT Codes

38206CPT Code

Bone marrow aspiration

Clinical Scenario

Used to evaluate hematopoietic function in SCID patients.

Documentation Requirements

Document indication for aspiration and findings.

Specialty Considerations

Pediatric hematology may require additional details on the patient's immunological status.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of immunodeficiencies, improving the ability to capture the nuances of conditions like SCID. This specificity aids in better tracking of patient outcomes and resource allocation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of immunodeficiencies, improving the ability to capture the nuances of conditions like SCID. This specificity aids in better tracking of patient outcomes and resource allocation.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of immunodeficiencies, improving the ability to capture the nuances of conditions like SCID. This specificity aids in better tracking of patient outcomes and resource allocation.

Resources

Clinical References

  • •
    Severe Combined Immunodeficiency (SCID) Foundation

Coding & Billing References

  • •
    Severe Combined Immunodeficiency (SCID) Foundation

Frequently Asked Questions

What are the common symptoms of SCID?

Common symptoms include recurrent infections, failure to thrive, and chronic diarrhea. Infants may present with severe infections shortly after birth.

How is SCID diagnosed?

Diagnosis is typically made through immunological testing, including lymphocyte subset analysis and genetic testing to identify specific mutations.

What treatments are available for SCID?

Treatment options include prophylactic antibiotics, immunoglobulin replacement therapy, and hematopoietic stem cell transplantation, which can be curative.