What is ICD-10 code D61.2?

D61.2 is the ICD-10-CM diagnosis code for Aplastic anemia due to other external agents. A serious condition where exposure to external agents (such as chemicals, radiation, or toxins) causes the bone marrow to stop producing blood cells. D61.2 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. D61.2 is part of the FY2026 ICD-10-CM code set published by the CMS National Center for Health Statistics and used on Medicare, Medicaid, and commercial claims in the United States.

Yes. D61.2 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. D61.2 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

What is the V28 vs V24 difference for D61.2?

CMS phased in the V28 risk adjustment model over payment years 2024 (33%), 2025 (67%), and 2026 (100%), replacing V24. V28 consolidates HCC categories, removes some lower-acuity conditions, and recalibrates RAF weights across the entire model. For D61.2, V28 maps to Hemolytic and Aplastic Anemias at RAF 0.291 while V24 mapped to Severe Hematological Disorders at RAF 0.666. Both models can still appear in legacy data and in payer-specific lookback periods.

What should coders know when reporting D61.2?

Document the specific external agent responsible (e.g., benzene, pesticides, radiation); include details about exposure duration and intensity Consider coding the external cause using Chapter 20 codes (V00-Y99) to capture the source of exposure Because D61.2 maps to a payment HCC, the documentation must also satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's risk adjustment score.

D61.2 ICD-10 Code: Aplastic anemia due to other

ICD-10-CM Code View

HCC Buddy Code Card

Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.

Code lookupD61.2Effective periodFY2026 Apr Update (Apr 1-Sep 30)

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)

D61.2

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

Aplastic anemia due to other external agents

A serious condition where exposure to external agents (such as chemicals, radiation, or toxins) causes the bone marrow to stop producing blood cells.

Buddy Insight

CMS-HCC V28

Mapped

HCC 109

Hemolytic and Aplastic Anemias

RAF 0.291

CMS-HCC V24

Mapped

HCC 46

Severe Hematological Disorders

RAF 0.666

ACA/HHS

Not risk-adjusted for this model/period.

RAF 0

ESRD/PACE

Mapped

HCC 46

Severe Hematological Disorders

RAF 0.0

RXHCC

Mapped

HCC 96

Hemolytic and Aplastic Anemias

RAF 0.0

Code Trumping

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Code Book Path

Official

D61Other aplastic anemias and other bone marrow failure syndromes

D61.2Aplastic anemia due to other external agents

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for D61.2 in this effective period.

Excludes 2

Official

neutropenia (D70.-)

Related Child Codes

Official

D61.0Constitutional aplastic anemia

D61.1Drug-induced aplastic anemia

D61.3Idiopathic aplastic anemia

D61.8Other specified aplastic anemias and other bone marrow failure syndromes

D61.9Aplastic anemia, unspecified

Includes

Official

ICD-10-CM does not list Includes notes for D61.2 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for D61.2 in this effective period.

Code First

Official

, if applicable, toxic effects of substances chiefly nonmedicinal as to source (T51-T65)

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for D61.2 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for D61.2 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

Document the specific external agent responsible (radiation type and dose, chemical name, toxin identity) with exposure duration and intensity.

Include occupational history and environmental exposure assessment.

Record complete blood count, bone marrow biopsy showing hypocellularity, and disease severity classification.

Document treatment approach and response.

MEAT Support

HCC Buddy guidance

Document the specific external agent responsible (radiation type and dose, chemical name, toxin identity) with exposure duration and intensity.

Include occupational history and environmental exposure assessment.

Record complete blood count, bone marrow biopsy showing hypocellularity, and disease severity classification.

Document treatment approach and response.

Audit Caution

HCC Buddy guidance

Always identify and code the specific external cause using Chapter 20 codes -

the aplastic anemia code alone does not capture the exposure circumstances. Distinguish acute radiation syndrome (which may include transient marrow suppression) from true aplastic anemia requiring ongoing management. Chronic low-dose benzene exposure may produce aplastic anemia years after exposure -

document the historical exposure. Consider whether the external agent exposure represents an occupational or environmental hazard requiring additional reporting.

Common Mistakes

HCC Buddy guidance

D61.1 (Drug-induced aplastic anemia) is specifically for medication-related causes.

D61.3 (Idiopathic aplastic anemia) is used when no external cause is identified.

D61.9 (Aplastic anemia, unspecified) does not specify the etiology.

D61.810 (Antineoplastic chemotherapy induced pancytopenia) is for intentional chemotherapy effects.

Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.

Is D61.2 an HCC code?

Yes. D61.2 maps to Hemolytic and Aplastic Anemias under the CMS-HCC V28 risk adjustment model (and Severe Hematological Disorders under V24).

HCC Category Mapping

V28HCC 109, Hemolytic and Aplastic Anemias

0.291

V24HCC 46, Severe Hematological Disorders

0.666

ESRDHCC 46, Severe Hematological Disorders

0.000

RxHCCHCC 96, Hemolytic and Aplastic Anemias

0.000

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 D61.2

For D61.2to 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 D61.2 during that encounter, not just copy-forwarded from a problem list.

What This Code Means

D61.2 is the ICD-10-CM diagnosis code for aplastic anemia due to other external agents. A serious condition where exposure to external agents (such as chemicals, radiation, or toxins) causes the bone marrow to stop producing blood cells. D61.2 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, D61.2 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, D61.2 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.

Document the specific external agent responsible (e.g., benzene, pesticides, radiation); include details about exposure duration and intensity. Because D61.2 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 D61.2 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Document the specific external agent responsible (e.g., benzene, pesticides, radiation); include details about exposure duration and intensity
•Consider coding the external cause using Chapter 20 codes (V00-Y99) to capture the source of exposure

Clinical Significance

Aplastic anemia due to other external agents encompasses bone marrow failure caused by non-drug environmental exposures including ionizing radiation (accidental or occupational), benzene and other industrial chemicals, pesticides, and certain toxins. Radiation-induced aplastic anemia severity depends on dose, with whole-body exposures above 2 Gray causing clinically significant marrow suppression. Chronic benzene exposure is a well-established cause of aplastic anemia and can also progress to myelodysplastic syndrome or acute leukemia due to its mutagenic properties.

Documentation Requirements

✓Document the specific external agent responsible (radiation type and dose, chemical name, toxin identity) with exposure duration and intensity.
✓Include occupational history and environmental exposure assessment.
✓Record complete blood count, bone marrow biopsy showing hypocellularity, and disease severity classification.
✓Document treatment approach and response.
✓Use Chapter 20 external cause codes (V00-Y99) to capture the source and circumstances of exposure.
✓Include any regulatory reporting requirements for occupational exposures.

Code First

, if applicable, toxic effects of substances chiefly nonmedicinal as to source (T51-T65)

Commonly Confused Codes

•D61.1 (Drug-induced aplastic anemia) is specifically for medication-related causes.
•D61.3 (Idiopathic aplastic anemia) is used when no external cause is identified.
•D61.9 (Aplastic anemia, unspecified) does not specify the etiology.
•D61.810 (Antineoplastic chemotherapy induced pancytopenia) is for intentional chemotherapy effects.
•T66 (Radiation sickness, unspecified) may be an additional code for radiation exposure cases.