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D60.9 ICD-10-CM Code: Acquired pure red cell aplasia, unspecified

D60.9 maps to CMS-HCC V28 109. A source-labeled RAF reference is available. Confirm the documented diagnosis and applicable coding requirements. MEAT criteria · RAF Calculator · HCC Buddy coding tools

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Code lookupD60.9

FY 2026 Apr update / Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism (D50-D89) / Aplastic and other anemias and other bone marrow failure syndromes (D60-D64)

D60.9

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Acquired pure red cell aplasia, unspecified

A condition where the bone marrow fails to produce red blood cells, but the specific type or cause is not specified.

Buddy the Bee presenting code insight

Buddy Insight

Acquired pure red cell aplasia, unspecified is assigned when a patient has documented selective failure of red blood cell production by the bone marrow but the documentation does not specify whether the condition is chronic, transient, or of another defined type.

OverviewRisk ModelsCode BookDocumentationAuditNotesEdition comparison

CMS-HCC V28

HCC 109

Coefficient HCC 109: 1.144 (Community Non-Dual Aged (CNA))

CMS-HCC V24

Historical

Historical

Not used for CY2026 payment

ACA/HHS

HCC 068

Code-level coefficient reference

ESRD/PACE

HCC 46

Code-level coefficient reference

RXHCC

HCC 96

Code-level coefficient reference

Code Book Path

Official
D60Acquired pure red cell aplasia [erythroblastopenia]D60.9Acquired pure red cell aplasia, unspecified

Inclusion Terms

Official

No inclusion terms are included in this display for D60.9. Check the code and parent instructions in the Code Book.

Excludes 2

Official
  • autoimmune disease (systemic) NOS (M35.9)Inherited from D50-D89
  • certain conditions originating in the perinatal period (P00-P96)Inherited from D50-D89
  • complications of pregnancy, childbirth and the puerperium (O00-O9A)Inherited from D50-D89
  • congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)Inherited from D50-D89
  • endocrine, nutritional and metabolic diseases (E00-E88)Inherited from D50-D89
  • human immunodeficiency virus [HIV] disease (B20)Inherited from D50-D89
  • injury, poisoning and certain other consequences of external causes (S00-T88)Inherited from D50-D89
  • neoplasms (C00-D49)Inherited from D50-D89
  • symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)Inherited from D50-D89

Related Codes

Official
D60.0Chronic acquired pure red cell aplasiaD60.1Transient acquired pure red cell aplasiaD60.8Other acquired pure red cell aplasias

Includes

Official
  • red cell aplasia (acquired) (adult) (with thymoma)Inherited from D60

Excludes 1

Official
  • congenital red cell aplasia (D61.01)Inherited from D60

Code First

Official

No Code First sequencing instructions are included in this display for D60.9. Check the code and parent instructions in the Code Book.

Use Additional

Official

No Use Additional Code instructions are included in this display for D60.9. Check the code and parent instructions in the Code Book.

Code Also

Official

No Code Also instructions are included in this display for D60.9. Check the code and parent instructions in the Code Book.

Buddy Documentation Tip

HCC Buddy guidance
Document bone marrow findings confirming selective erythroid aplasia.
Record hemoglobin levels, reticulocyte count, and preserved white blood cell and platelet counts.
Include what diagnostic workup has been performed to determine the etiology and chronicity.
Submit a provider query to clarify whether the condition is chronic (D60.0), transient (D60.1), or another specified type (D60.8).

MEAT Support

HCC Buddy guidance
Document bone marrow findings confirming selective erythroid aplasia.
Record hemoglobin levels, reticulocyte count, and preserved white blood cell and platelet counts.
Include what diagnostic workup has been performed to determine the etiology and chronicity.
Submit a provider query to clarify whether the condition is chronic (D60.0), transient (D60.1), or another specified type (D60.8).

Audit Caution

HCC Buddy guidance
Always attempt to determine chronicity through provider query before accepting this unspecified code.
Review the duration of symptoms and presence of associated conditions (thymoma, autoimmune disease) to guide more specific code selection.
Do not confuse isolated red cell aplasia with aplastic anemia, which affects all blood cell lineages.
Unspecified codes face increased audit scrutiny in risk adjustment reviews.

Common Mistakes

HCC Buddy guidance
D60.0 (Chronic acquired pure red cell aplasia) should be used when chronicity is established.
D60.1 (Transient acquired pure red cell aplasia) applies to self-resolving episodes.
D61.9 (Aplastic anemia, unspecified) involves failure of all cell lines, not just erythroid.
D64.9 (Anemia, unspecified) does not specify the mechanism and is far less informative.

Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →

Is D60.9 an HCC code?

Yes. D60.9 (Acquired pure red cell aplasia, unspecified) maps to HCC 109, Acquired Hemolytic, Aplastic, and Sideroblastic Anemias under the CMS-HCC V28 risk adjustment model, with a source-labeled community non-dual aged reference coefficient of 1.144. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes. It is billable for payment year 2026.

Coder answer: D60.9 is billable and maps to V28 HCC 109, Acquired Hemolytic, Aplastic, and Sideroblastic Anemias. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.

Code
D60.9
Description
Acquired pure red cell aplasia, unspecified
HCC (V28)
HCC 109 — Acquired Hemolytic, Aplastic, and Sideroblastic Anemias
RAF reference coefficient
1.144
Billable
Yes
Payment year
2026

HCC Category Mapping

V28HCC 109, Acquired Hemolytic, Aplastic, and Sideroblastic Anemias
1.144
ESRDHCC 46, Severe Hematological Disorders
Not separately weighted
RxHCCHCC 96, Acquired Hemolytic, Aplastic, and Sideroblastic Anemias
Not separately weighted

These are source-labeled model coefficients, not member totals. A category may still be removed by hierarchy or model cleanup rules. Weights are not directly comparable across models: CMS-HCC V28 and V24 use Community, Non-Dual, Aged; ESRD uses the dialysis continuing-enrollee model; RxHCC is the Part D continuing-enrollee, non-low-income, aged weight (a larger scale than CMS-HCC). ACA/HHS has no single weight — it varies by metal level. Actual per-patient RAF contribution depends on member context, hierarchy and cleanup rules, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains available for historical review.

Work D60.9 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT review for D60.9

For D60.9, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule.

  • 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

Coder workflow notes

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What This Code Means

D60.9 is the ICD-10-CM diagnosis code for acquired pure red cell aplasia, unspecified. A condition where the bone marrow fails to produce red blood cells, but the specific type or cause is not specified. D60.9 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, D60.9 maps to Acquired Hemolytic, Aplastic, and Sideroblastic Anemias (HCC 109) with a source-labeled community, non-dual, aged reference coefficient of 1.144. No V24 mapping is shown for D60.9; use the applicable model and payment year when reviewing the V28 mapping. For CY2026 non-PACE Medicare Advantage, CMS uses 100% of the 2024 CMS-HCC model (V28). PACE uses a separate model blend. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes.

This is an unspecified code; query the provider to determine if the condition is chronic (D60.0) or transient (D60.1). For D60.9, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule. 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, source-labeled coefficient references, and MEAT documentation criteria for D60.9 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • •This is an unspecified code; query the provider to determine if the condition is chronic (D60.0) or transient (D60.1)
  • •Avoid using this code when more specific information is available in the medical record

Clinical Significance

Acquired pure red cell aplasia, unspecified is assigned when a patient has documented selective failure of red blood cell production by the bone marrow but the documentation does not specify whether the condition is chronic, transient, or of another defined type. This code represents a documentation gap that should prompt a provider query, as the distinction between chronic and transient forms has significant implications for prognosis, workup (thymoma screening in chronic forms), and treatment approach.

Documentation Requirements

  • ✓Document bone marrow findings confirming selective erythroid aplasia.
  • ✓Record hemoglobin levels, reticulocyte count, and preserved white blood cell and platelet counts.
  • ✓Include what diagnostic workup has been performed to determine the etiology and chronicity.
  • ✓Submit a provider query to clarify whether the condition is chronic (D60.0), transient (D60.1), or another specified type (D60.8).
  • ✓Document any treatment provided and response.

Commonly Confused Codes

  • •D60.0 (Chronic acquired pure red cell aplasia) should be used when chronicity is established.
  • •D60.1 (Transient acquired pure red cell aplasia) applies to self-resolving episodes.
  • •D61.9 (Aplastic anemia, unspecified) involves failure of all cell lines, not just erythroid.
  • •D64.9 (Anemia, unspecified) does not specify the mechanism and is far less informative.

Child Codes

D60.0Chronic acquired pure red cell aplasia
HCC 109
D60.1Transient acquired pure red cell aplasia
D60.8Other acquired pure red cell aplasias
HCC 109
D60.9Acquired pure red cell aplasia, unspecified
HCC 109

Code Hierarchy

└D60Acquired pure red cell aplasia [erythroblastopenia]└D60.9Acquired pure red cell aplasia, unspecified
└D60.9Acquired pure red cell aplasia, unspecified

Also searched as

  • D60 9
  • D609

For D60.9, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule.

D60.9 maps to CMS-HCC V28 category 109, Acquired Hemolytic, Aplastic, and Sideroblastic Anemias. See the ICD-10 to HCC mapping hub for how the V28 crosswalk works. The mapping identifies a payment HCC category for D60.9. Review its source-labeled HCC coefficient above, check the RAF Calculator with complete member context for CMS-HCC V28 PY2026, and confirm the documentation the chart needs before the code is submitted. HCC Buddy shows no RAF score unless every required source and calculation check passes.

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Open D60.9 in the Code Book for the full Index-to-Tabular path, MEAT checklist, and V28 HCC mapping, or in the Encoder to code from a keyword search. Pro includes 7 days to try everything, no card required.

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