2025 ICD-10-CM code D61.1
Drug-induced aplastic anemia. Use additional code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5).
Medical necessity for treatment of drug-induced aplastic anemia is established by the severity of the condition.This is determined by the degree of pancytopenia (reduction in all blood cell types) and the resulting clinical manifestations (e.g., anemia, infections, bleeding).Treatment, including transfusions, medications, and even bone marrow transplantation, is medically necessary when the patient's health is significantly compromised.
Physicians need to diagnose drug-induced aplastic anemia based on patient history, physical examination, and laboratory tests such as complete blood count (CBC), peripheral blood smear, hemoglobin electrophoresis, kidney and liver function studies, and bone marrow biopsy. Treatment depends on the severity and may involve supportive care, immunosuppression therapy, or hematopoietic cell transplantation.
- Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism (D50-D89)
- D61-D64: Aplastic and other anemias and other bone marrow failure syndromes
In simple words: Drug-induced aplastic anemia is a blood disorder where your bone marrow can't make enough new blood cells because of certain medicines you've taken. This can make you feel tired, dizzy, short of breath, and more prone to infections and bleeding.
Drug-induced aplastic anemia is a condition where the bone marrow fails to produce sufficient blood cells due to the toxic effects of certain medications.This leads to a decrease in red blood cells (causing anemia), white blood cells (increasing infection risk), and platelets (impairing blood clotting).
Example 1: A patient receiving chemotherapy for cancer develops severe anemia, frequent infections, and unexplained bruising.A bone marrow biopsy reveals significantly reduced blood cell production, and the diagnosis is drug-induced aplastic anemia (D61.1) due to the chemotherapy drugs. An additional code from the T36-T50 range with a fifth or sixth character 5 should be used to specify the causative chemotherapy drug., A patient taking an anti-thyroid medication develops persistent fatigue and weakness. Blood tests reveal pancytopenia. After other causes are ruled out, the anti-thyroid drug is identified as the cause, and the diagnosis is drug-induced aplastic anemia (D61.1). An additional code from the T36-T50 range should be assigned to specify the anti-thyroid medication causing the adverse effect., A patient on long-term NSAID therapy for arthritis experiences increased bleeding and bruising. Subsequent blood work reveals low platelet and red blood cell counts.After excluding other potential causes, the NSAID is determined to be the culprit, leading to a diagnosis of drug-induced aplastic anemia (D61.1). An additional T code for adverse effect of the specific NSAID should be included.
Documentation should include evidence of the aplastic anemia (e.g., low blood cell counts, bone marrow biopsy results), the causative drug, and any related signs and symptoms. If the drug is an antineoplastic agent used for chemotherapy, document this clearly.
** For cases of aplastic anemia due to antineoplastic chemotherapy, consider also D61.810 (Antineoplastic chemotherapy induced pancytopenia) if documentation supports this as a more appropriate code.
- Specialties:Hematology, Oncology, Internal Medicine
- Place of Service:Inpatient Hospital, Outpatient Hospital, Office