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ICD-10-CM D61.811: Other drug-induced pancytopenia

D61.811 is the billable ICD-10-CM code for other drug-induced pancytopenia, in category D61 (Other aplastic anemias and other bone marrow failure syndromes) of the Aplastic and other anemias and other bone marrow failure syndromes section. As a principal diagnosis it groups to MS-DRG 808 Major Hematological and Immunological Diagnoses Except Sickle Cell Crisis and Coagulation Disorders with MCC, MS-DRG 809 Major Hematological and Immunological Diagnoses Except Sickle Cell Crisis and Coagulation Disorders with CC, MS-DRG 810 Major Hematological and Immunological Diagnoses Except Sickle Cell Crisis and Coagulation Disorders without CC/MCC (MDC 16 MDC 16: Diseases and Disorders of Blood, Blood Forming Organs and Immunologic Disorders). As a secondary diagnosis it is an MCC, excluded with 41 principal diagnoses. 14 LCD billing and coding articles list it as covered.

Compiled from CMS files by the QuickIntell RCM Editorial Team · Data effective · Method: reference methodology · Report a data correction

Data currency: ICD-10-CM code descriptions: FY2027 (effective October 1, 2026); IPPS Table 5 (MS-DRG weights): v44 FY2027 (final rule + CN3) (effective October 1, 2026); ICD-10-CM to HCC mapping: PY2027 initial ICD-10-CM mappings (dates of service 2026) (payment year 2027); Medicare Coverage Database billing and coding articles: MCD release October 8, 2026 (effective October 4, 2026). Next CMS release: FY2028 code files, effective October 1, 2027 for the ICD-10-CM code descriptions; FY2028 final rule (August 2027), effective October 1, 2027; an April 1 interim grouper update when CMS issues one for the IPPS Table 5 (MS-DRG weights); PY2028 advance notice (February 2027) and the PY2027 midyear final mapping (spring 2027) for the ICD-10-CM to HCC mapping; weekly, every Thursday for the Medicare Coverage Database billing and coding articles.

Code
D61.811
billable FY2027 ICD-10-CM code
Category
D61 Other aplastic anemias and other bone marrow failure syndromes
Chapter
3: Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism (D50-D89)
CC/MCC (MS-DRG v44)
MCC
CMS-HCC V28
Not mapped
POA reporting
Required

Tabular list notes for D61.811

The tabular list has no notes on D61.811 itself; the notes below apply from its parent headings.

Inherited from D61 (Other aplastic anemias and other bone marrow failure syndromes)

Excludes2 (not part of this condition, may be coded together)
  • neutropenia (D70.-)

Inherited from D61.81 (Pancytopenia)

Excludes1 (never coded together)
  • pancytopenia (due to) (with) aplastic anemia (D61.9)
  • pancytopenia (due to) (with) bone marrow infiltration (D61.82)
  • pancytopenia (due to) (with) congenital (pure) red cell aplasia (D61.01)
  • pancytopenia (due to) (with) hairy cell leukemia (C91.4-)
  • pancytopenia (due to) (with) human immunodeficiency virus disease (B20.-)
  • pancytopenia (due to) (with) leukoerythroblastic anemia (D61.82)
  • pancytopenia (due to) (with) myeloproliferative disease (D47.1)
Excludes2 (not part of this condition, may be coded together)
  • pancytopenia (due to) (with) myelodysplastic syndromes (D46.-)

MS-DRG grouping when D61.811 is the principal diagnosis

MS-DRG v44 groups for D61.811 as principal diagnosis
MDCMS-DRGs
16 MDC 16: Diseases and Disorders of Blood, Blood Forming Organs and Immunologic Disorders808809810

The final group also depends on procedures, secondary diagnoses and discharge status; the MS-DRG lookup for D61.811 shows the full grouping logic.

CC/MCC status and inpatient edits

As a secondary diagnosis, D61.811 is an MCC under MS-DRG v44, unless the principal diagnosis is one of the 41 codes in its exclusion list. Check D61.811 against a principal diagnosis.

  • Present on admission: a POA indicator is required on inpatient claims.

CMS-HCC V28 risk adjustment

D61.811 does not map to a payment HCC in the PY2027 CMS-HCC V28 model, so on its own it does not change a Medicare Advantage risk score.

LCD billing and coding articles that list D61.811

14 current Medicare billing and coding articles list D61.811 among the diagnoses that support medical necessity for the services they cover.

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Frequently asked questions

What does ICD-10-CM D61.811 mean?

D61.811 means other drug-induced pancytopenia. It is one of 13 billable codes under D61, other aplastic anemias and other bone marrow failure syndromes.

What can't be coded with D61.811?

Excludes1 at D61.81: pancytopenia (due to) (with) aplastic anemia (D61.9); pancytopenia (due to) (with) bone marrow infiltration (D61.82); pancytopenia (due to) (with) congenital (pure) red cell aplasia (D61.01); pancytopenia (due to) (with) hairy cell leukemia (C91.4-) and 3 more. These are never reported together with D61.811.

Which MS-DRG does D61.811 group to?

As the principal diagnosis, D61.811 groups to MS-DRG 808 Major Hematological and Immunological Diagnoses Except Sickle Cell Crisis and Coagulation Disorders with MCC, MS-DRG 809 Major Hematological and Immunological Diagnoses Except Sickle Cell Crisis and Coagulation Disorders with CC, MS-DRG 810 Major Hematological and Immunological Diagnoses Except Sickle Cell Crisis and Coagulation Disorders without CC/MCC (MDC 16 MDC 16: Diseases and Disorders of Blood, Blood Forming Organs and Immunologic Disorders) under MS-DRG v44, before procedures and secondary diagnoses are applied.

Is D61.811 a CC or MCC?

D61.811 is an MCC under MS-DRG v44; 41 principal diagnoses exclude it.

Sources

Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-10. Verify against the primary file before billing or contracting decisions. The reference methodology explains how each figure is computed from these files.

Disclaimer

The descriptor and notes are reproduced from the FY2027 ICD-10-CM files; MS-DRG, CC/MCC and HCC facts come from the CMS FY2027 and PY2027 tables. Code from the medical record and the ICD-10-CM Official Guidelines. Not legal, clinical or billing advice.

Found a figure that does not match the CMS file? Report a data correction with the CMS file and the value you expected; the request reaches the editorial team through the contact form.