D60.0
BillableChronic acquired pure red cell aplasia
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is D60.0 an HCC code?
Yes. D60.0 maps to Hemolytic and Aplastic Anemias under the CMS-HCC V28 risk adjustment model (and Severe Hematological Disorders under V24).
HCC Category Mapping
RAF weights shown are the community, non-dual, aged base weights from the CMS risk adjustment model file. Actual per-patient RAF contribution depends on member segment, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains in use during the transition and for historical data.
MEAT Criteria for D60.0
For D60.0 to count as a valid HCC diagnosis in a given encounter, the provider's documentation must show MEAT: Monitor, Evaluate, Assess, or Treat. A diagnosis from a prior year does not carry forward automatically — it has to be re-documented and supported each calendar year.
- MMonitor: signs, symptoms, disease progression, or lab trending documented in the note
- EEvaluate: test results, medication response, or physical findings reviewed by the provider
- AAssess: explicit mention in the assessment or plan with acknowledgment of status
- TTreat: medication, referral, procedure, therapy, or counseling tied to the diagnosis
Only one of M/E/A/T is required to support the code, but the documentation must be specific enough to show that the provider actually addressed D60.0 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
D60.0 is the ICD-10-CM diagnosis code for chronic acquired pure red cell aplasia. A long-term condition where the bone marrow fails to produce red blood cells while other blood cell production remains normal. D60.0 sits in the ICD-10-CM chapter for diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism (d50-d89), within the section covering aplastic and other anemias and other bone marrow failure syndromes (d60-d64).
Under the CMS-HCC V28 risk adjustment model, D60.0 maps to Hemolytic and Aplastic Anemias (HCC 109) with a community, non-dual, aged base RAF weight of 0.291. Under the older CMS-HCC V24 model, D60.0 maps to Severe Hematological Disorders (HCC 46) with a community, non-dual, aged base RAF weight of 0.666. V28 is the CMS-HCC risk adjustment model that reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition.
This code indicates a chronic/persistent condition; document the duration and any treatment responses in the medical record. Because D60.0 maps to a payment HCC, the provider's documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's Medicare Advantage risk adjustment score. When documentation is ambiguous, coders should issue a provider query rather than assume the highest-specificity variant.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for D60.0 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This code indicates a chronic/persistent condition; document the duration and any treatment responses in the medical record
- •Distinguish from transient forms (D60.1) by confirming the condition has lasted more than a few weeks
Clinical Significance
Chronic acquired pure red cell aplasia is a rare hematological condition where the bone marrow selectively fails to produce red blood cell precursors while maintaining normal white blood cell and platelet production. The chronic designation indicates persistence beyond weeks to months, distinguishing it from transient forms. Common associations include thymoma (up to 50% of cases), autoimmune disorders, lymphoproliferative diseases, and parvovirus B19 persistence in immunocompromised patients. Patients typically present with severe normocytic anemia with absent reticulocytes.
Documentation Requirements
- ✓Document bone marrow biopsy findings showing absent or near-absent erythroid precursors with preserved myeloid and megakaryocytic lineages.
- ✓Record hemoglobin levels, reticulocyte count (characteristically near zero), and normal white blood cell and platelet counts.
- ✓Include workup for underlying causes: computed tomography chest for thymoma, parvovirus B19 testing, autoimmune serologies, and lymphoproliferative disease screening.
- ✓Document treatment response to immunosuppressive therapy, erythropoietin, or thymectomy if applicable.
Commonly Confused Codes
- •D60.1 (Transient acquired pure red cell aplasia) is for temporary episodes resolving within weeks.
- •D60.9 (Acquired pure red cell aplasia, unspecified) does not specify chronicity.
- •D61.01 (Constitutional pure red blood cell aplasia) also known as Diamond-Blackfan anemia is congenital, not acquired.
- •D61.9 (Aplastic anemia, unspecified) involves all cell lines, not isolated red cell failure.