What is ICD-10 code D61.810?

D61.810 is the ICD-10-CM diagnosis code for Antineoplastic chemotherapy induced pancytopenia. A condition where chemotherapy drugs used to treat cancer cause a dangerous drop in all types of blood cells produced by the bone marrow. D61.810 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. D61.810 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. D61.810 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. D61.810 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.

Which HCC does D61.810 map to under V28?

D61.810 does not map to a CMS-HCC V28 payment category. Check the current CMS-HCC V28 model file for payment year 2026 rather than an older V24 tip sheet.

What does D61.810 pay in RAF?

D61.810 has no separately stated V28 community RAF weight. If it is not a V28 payment HCC, it adds nothing to a community RAF score.

What is the V28 vs V24 difference for D61.810?

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. D61.810 was a payment HCC under V24 (Disorders of Immunity) but the V28 recalibration removed it from the risk adjustment model. Both models can still appear in legacy data and in payer-specific lookback periods.

2026 ICD-10-CM D61.810: Antineoplastic chemotherapy

D61.810 is not a CMS-HCC payment code. MEAT criteria · RAF calculator · HCC coding software

ICD-10-CM Code View

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Code lookupD61.810Effective 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)

D61.810

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

Antineoplastic chemotherapy induced pancytopenia

A condition where chemotherapy drugs used to treat cancer cause a dangerous drop in all types of blood cells produced by the bone marrow.

Buddy Insight

CMS-HCC V28

N/A

—

Not risk-adjusted for this model/period.

Not mapped

CMS-HCC V24

Mapped

HCC 47

Disorders of Immunity

RAF 0.665

ACA/HHS

N/A

—

Not risk-adjusted for this model/period.

Not mapped

ESRD/PACE

Mapped

HCC 47

Disorders of Immunity

RAF 0.078

RXHCC

N/A

—

Not risk-adjusted for this model/period.

Not mapped

Code Book Path

Official

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

D61.81Pancytopenia

D61.810Antineoplastic chemotherapy induced pancytopenia

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for D61.810 in this effective period.

Excludes 2

Official

aplastic anemia due to antineoplastic chemotherapy (D61.1)

Related Child Codes

Official

D61.811Other drug-induced pancytopenia

D61.818Other pancytopenia

Includes

Official

ICD-10-CM does not list Includes notes for D61.810 in this effective period.

Excludes 1

Official

pancytopenia (due to) (with) aplastic anemia (D61.9)
pancytopenia (due to) (with) bone marrow infiltration (D61.82)
pancytopenia (due to) (with) congenital (pure) red cell aplasia (D61.01)
pancytopenia (due to) (with) hairy cell leukemia (C91.4-)
pancytopenia (due to) (with) human immunodeficiency virus disease (B20.-)

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for D61.810 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for D61.810 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for D61.810 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

Document the specific chemotherapy regimen causing pancytopenia.

Record all three cytopenia values: hemoglobin, absolute neutrophil count, and platelet count.

Include the underlying malignancy being treated and the temporal relationship between chemotherapy administration and pancytopenia onset.

Document nadir blood counts and duration of pancytopenia.

MEAT Support

HCC Buddy guidance

Document the specific chemotherapy regimen causing pancytopenia.

Record all three cytopenia values: hemoglobin, absolute neutrophil count, and platelet count.

Include the underlying malignancy being treated and the temporal relationship between chemotherapy administration and pancytopenia onset.

Document nadir blood counts and duration of pancytopenia.

Audit Caution

HCC Buddy guidance

Use this code when all three cell lines are suppressed -

if only one or two lines are affected, use the specific cytopenia code instead (D64.81 for anemia alone, D70.1 for neutropenia alone). Always link to the underlying neoplasm code and the chemotherapy encounter. Distinguish expected myelosuppression (which resolves between cycles) from treatment-related aplastic anemia (which may be prolonged and requires different management). Do not use this code for pancytopenia from the malignancy itself (marrow infiltration).

Common Mistakes

HCC Buddy guidance

D61.811 (Other drug-induced pancytopenia) is for non-chemotherapy medications.

D61.818 (Other pancytopenia) covers non-drug causes.

D61.1 (Drug-induced aplastic anemia) represents more severe, prolonged bone marrow failure rather than expected treatment-related myelosuppression.

D70.1 (Agranulocytosis secondary to cancer chemotherapy) codes only the neutropenia component.

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 D61.810 an HCC code?

Yes. D61.810 maps to Disorders of Immunity under the V24 model but is not retained in V28.

Code: D61.810
Description: Antineoplastic chemotherapy induced pancytopenia
HCC (V28): No CMS-HCC V28 mapping
RAF: —
Billable: Yes
Payment year: 2026

HCC Category Mapping

V24HCC 47, Disorders of Immunity

0.665

ESRDHCC 47, Disorders of Immunity

0.078

Each model's RAF is its CMS base weight for that model's standard population, so 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 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.

Work D61.810 in the Code Book — tabular path, V28 RAF, and MEAT checklist →

MEAT Criteria for D61.810

For D61.810 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 D61.810 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

D61.810 is the ICD-10-CM diagnosis code for antineoplastic chemotherapy induced pancytopenia. A condition where chemotherapy drugs used to treat cancer cause a dangerous drop in all types of blood cells produced by the bone marrow. D61.810 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 older CMS-HCC V24 model, D61.810 maps to Disorders of Immunity (HCC 47) with a community, non-dual, aged base RAF weight of 0.665. 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.

Always link this code to the underlying neoplasm code and the chemotherapy encounter code. Because D61.810 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 D61.810 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Always link this code to the underlying neoplasm code and the chemotherapy encounter code
•Document the specific chemotherapy agent if available to support medical necessity

Clinical Significance

Antineoplastic chemotherapy induced pancytopenia is a common and expected complication of cancer chemotherapy where cytotoxic agents suppress all bone marrow cell lines, resulting in simultaneous anemia, neutropenia, and thrombocytopenia. The severity and duration of pancytopenia depend on the specific agents used, dose intensity, and patient factors including prior treatment, bone marrow reserve, and nutritional status. This condition represents a significant source of treatment morbidity including life-threatening infections, hemorrhage, and transfusion dependence.

Documentation Requirements

✓Document the specific chemotherapy regimen causing pancytopenia.
✓Record all three cytopenia values: hemoglobin, absolute neutrophil count, and platelet count.
✓Include the underlying malignancy being treated and the temporal relationship between chemotherapy administration and pancytopenia onset.
✓Document nadir blood counts and duration of pancytopenia.
✓Record supportive measures including growth factor support (granulocyte colony-stimulating factor), transfusions, infection prophylaxis, and any treatment delays or dose modifications resulting from pancytopenia.

Excludes 2, Not included here, may code separately

aplastic anemia due to antineoplastic chemotherapy (D61.1)

Commonly Confused Codes

•D61.811 (Other drug-induced pancytopenia) is for non-chemotherapy medications.
•D61.818 (Other pancytopenia) covers non-drug causes.
•D61.1 (Drug-induced aplastic anemia) represents more severe, prolonged bone marrow failure rather than expected treatment-related myelosuppression.
•D70.1 (Agranulocytosis secondary to cancer chemotherapy) codes only the neutropenia component.
•D64.81 (Anemia due to antineoplastic chemotherapy) codes only the anemia component.