D61.811

HCC Category Mapping

What This Code Means

This condition occurs when certain medications cause a significant decrease in all three types of blood cells (red blood cells, white blood cells, and platelets), resulting in anemia, increased infection risk, and bleeding problems. It's a serious side effect that requires stopping the offending drug and close medical monitoring.

Coding Tips

• •Always identify and document the specific drug causing the pancytopenia, as this should be coded separately using a drug toxicity code (T36-T50 series) with the appropriate 5th or 6th character for adverse effect
• •Ensure the pancytopenia is clearly documented as drug-induced in the medical record; distinguish this code from other causes of pancytopenia (aplastic anemia, nutritional deficiencies, or other conditions)

Clinical Significance

Other drug-induced pancytopenia describes the dangerous reduction of all three blood cell lines caused by non-chemotherapy medications, resulting in anemia, neutropenia, and thrombocytopenia simultaneously. Common causative agents include methotrexate (at non-oncologic doses for autoimmune disease), azathioprine, mycophenolate, sulfasalazine, carbamazepine, and certain antiviral agents. Unlike chemotherapy-induced pancytopenia, this is typically an unexpected adverse drug reaction that requires immediate drug discontinuation and may necessitate prolonged supportive care while awaiting bone marrow recovery.

Documentation Requirements

• ✓Document the specific causative medication by name with temporal relationship between drug exposure and pancytopenia onset.
• ✓Record all three cytopenia values: hemoglobin, absolute neutrophil count, and platelet count.
• ✓Include the indication for the offending medication and whether it has been discontinued.
• ✓Use external cause codes (T36-T50) to identify the responsible drug with adverse effect intent.
• ✓Document bone marrow biopsy results if performed, supportive measures, and timeline to recovery.

Commonly Confused Codes