D61.1

Billable

Drug-induced aplastic anemia

HCC Category Mapping

V24HCC 46 — Severe Hematological Disorders

0.666

ESRDHCC 46 — Severe Hematological Disorders

0.000

RxHCCHCC 96 — Hemolytic and Aplastic Anemias

0.000

What This Code Means

A serious condition where medications or drugs cause the bone marrow to stop producing blood cells.

Coding Tips

•Document the specific drug or medication causing the aplastic anemia; link the temporal relationship between drug exposure and symptom onset
•Include the drug name in the medical record and consider using an additional code for the adverse effect if applicable

Clinical Significance

Drug-induced aplastic anemia is a severe and potentially fatal condition where medication exposure triggers destruction or suppression of hematopoietic stem cells, resulting in pancytopenia (low red cells, white cells, and platelets). Unlike drug-induced cytopenias affecting single cell lines, aplastic anemia represents failure of the entire bone marrow. High-risk medications include chloramphenicol, carbamazepine, phenytoin, sulfonamides, gold compounds, and certain chemotherapy agents. The mechanism may involve direct toxicity or idiosyncratic immune-mediated stem cell destruction.

Documentation Requirements

✓Document the specific causative drug by name with clear temporal relationship between drug exposure and aplastic anemia onset.
✓Record complete blood count showing pancytopenia and bone marrow biopsy demonstrating hypocellularity.
✓Include the severity classification (moderate, severe, or very severe aplastic anemia based on absolute neutrophil count, platelet count, and reticulocyte count).
✓Document treatment with drug discontinuation, immunosuppressive therapy, supportive transfusions, or stem cell transplant.
✓Use external cause codes (T36-T50) to identify the responsible drug.

Use Additional Code

code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5)

Commonly Confused Codes

D61.810 (Antineoplastic chemotherapy induced pancytopenia) is more specific when chemotherapy is the cause.D61.811 (Other drug-induced pancytopenia) addresses pancytopenia specifically rather than aplastic anemia.D61.2 (Aplastic anemia due to other external agents) covers non-drug causes like radiation or chemicals.D61.3 (Idiopathic aplastic anemia) is used when no cause is identified.D61.9 (Aplastic anemia, unspecified) does not identify the drug-induced etiology.

Code Hierarchy

└D61Other aplastic anemias and other bone marrow failure syndromes └D61.1Drug-induced aplastic anemia

└D61.1Drug-induced aplastic anemia