D61.09
BillableOther constitutional aplastic anemia
HCC Category Mapping
What This Code Means
This is a rare blood disorder where the bone marrow fails to produce enough blood cells (red blood cells, white blood cells, and platelets) due to an inherited or constitutional condition that is not otherwise specified. Patients with this condition are at risk for infections, bleeding, and severe anemia.
Coding Tips
- •Verify the specific type of constitutional aplastic anemia in the medical record, as code D61.09 is used only when the condition doesn't fit more specific subtypes like Fanconi anemia (D61.09 excludes D61.01)
- •Document whether the condition is congenital or acquired, and look for any associated conditions or complications that may require additional codes
Clinical Significance
Other constitutional aplastic anemia captures rare inherited bone marrow failure syndromes not classified under Diamond-Blackfan anemia, Shwachman-Diamond syndrome, or Fanconi anemia. This includes conditions such as dyskeratosis congenita (telomere biology disorders), congenital amegakaryocytic thrombocytopenia that progresses to aplasia, and other genetic bone marrow failure syndromes identified through advances in genetic testing. These rare conditions share the features of inherited bone marrow failure with varying patterns of cytopenia and associated clinical manifestations.
Documentation Requirements
- ✓Document the specific constitutional aplastic anemia syndrome by name when identified.
- ✓Include genetic testing results confirming the inherited nature.
- ✓Record complete blood count values, bone marrow biopsy findings, and any characteristic physical features associated with the specific syndrome.
- ✓Document family history of bone marrow failure or related conditions.
- ✓Note treatment approach including supportive care, stem cell transplant considerations, and any malignancy surveillance.