D72.0
BillableGenetic anomalies of leukocytes
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is D72.0 an HCC code?
Yes. D72.0 maps to Disorders of Immunity, Neutropenia under the CMS-HCC V28 risk adjustment model (and Disorders of Immunity under V24).
HCC Category Mapping
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 D72.0
For D72.0 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 D72.0 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
D72.0 is the ICD-10-CM diagnosis code for genetic anomalies of leukocytes. A group of inherited disorders affecting the structure or development of white blood cells from birth. D72.0 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 other disorders of blood and blood-forming organs (d70-d77).
Under the CMS-HCC V28 risk adjustment model, D72.0 maps to Disorders of Immunity, Neutropenia (HCC 115) with a community, non-dual, aged base RAF weight of 0.369. Under the older CMS-HCC V24 model, D72.0 maps to Disorders of Immunity (HCC 47) with a community, non-dual, aged base RAF weight of 0.472. 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.
This code represents congenital/genetic conditions; verify family history and genetic testing results in the medical record. Because D72.0 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 D72.0 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This code represents congenital/genetic conditions; verify family history and genetic testing results in the medical record.
- •Do not use this code for acquired white blood cell abnormalities; those require different coding.
Clinical Significance
Genetic anomalies of leukocytes encompass inherited conditions affecting white blood cell morphology or function, including Pelger-Huet anomaly (hypolobulated neutrophils), Alder-Reilly anomaly (abnormal granulation), Chediak-Higashi syndrome (giant granules with immunodeficiency), and other rare hereditary leukocyte disorders. Clinical significance varies from benign morphological variants to severe immunodeficiency syndromes.
Documentation Requirements
- ✓Document the specific leukocyte anomaly identified, peripheral blood smear or flow cytometry findings, genetic testing results if available, and clinical manifestations (recurrent infections, albinism in Chediak-Higashi).
- ✓Record family history consistent with the specific inheritance pattern and any associated features.
Excludes 1 — Do NOT code together
- Chédiak (-Steinbrinck)-Higashi syndrome (E70.330)