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2025 ICD-10-CM code D61.818

Other pancytopenia. This code is used when the pancytopenia is not caused by any of the specific reasons listed in the other pancytopenia codes.

Do not code pancytopenia with aplastic anemia or other specific causes if documented. Use other pancytopenia (D61.818) only when other specific causes are ruled out, including drug-induced, chemotherapy-induced or related to another underlying condition. If pancytopenia occurs with myelodysplastic syndromes, report both codes with the myelodysplastic syndrome as primary followed by other pancytopenia (D61.818).

The medical necessity for the workup and treatment of pancytopenia must be documented. This includes the severity of the cytopenias, the presence of related symptoms, and the impact on the patient's overall health status.The rationale for any specific treatments like transfusions, medications, or bone marrow transplantation should be clearly documented based on established guidelines and the individual patient's clinical needs.

The provider's responsibilities include diagnosing pancytopenia based on the patient's medical history, physical examination, and symptoms such as weakness, fatigue, dizziness, fever, shortness of breath, paleness, bruising, petechiae, purpura, nosebleeds, rapid heart rate, confusion, and seizures.Laboratory tests, including a complete blood count (CBC), peripheral blood smear, and potentially a bone marrow biopsy are necessary for diagnosis.Treatment for pancytopenia varies depending on the cause and severity and can include supportive care, blood transfusions, antibiotics to treat infections, and medications to stimulate blood cell production. Bone marrow transplant may be an option for some.If caused by drugs or chemicals, removal of the causative agent often leads to improvement.

In simple words: Pancytopenia is a blood disorder where your body doesn't produce enough red blood cells, white blood cells, and platelets. This code is used when the cause isn't something like chemotherapy or a specific drug.

Pancytopenia is a condition characterized by a decrease in the number of red blood cells, white blood cells, and platelets in the blood. This condition can be caused by a variety of factors, including certain medications, infections, radiation therapy, chemotherapy, and bone marrow disorders. “Other” pancytopenia specifies that the condition is not due to antineoplastic chemotherapy or other drugs and is not related to other specific conditions such as aplastic anemia.

Example 1: A 50-year-old patient presents with fatigue, easy bruising, and recurrent infections. Blood tests reveal low levels of red blood cells, white blood cells, and platelets. Further investigation does not reveal any specific cause for the pancytopenia, such as drug-induced or chemotherapy-induced causes, or any other underlying medical condition. The patient is diagnosed with other pancytopenia (D61.818)., A 30-year-old patient with a history of viral infection develops symptoms of fatigue, pallor, and frequent infections.After undergoing diagnostic testing, including blood tests and bone marrow biopsy, the patient is diagnosed with other pancytopenia (D61.818), as no other specified cause is identified., A patient presents with symptoms of anemia, including fatigue, shortness of breath, and pallor. Upon examination and testing, including a complete blood count and bone marrow examination, it is determined the patient has pancytopenia not attributable to any specific etiology. This presentation is consistent with other pancytopenia (D61.818).

Documentation should include complete blood count (CBC) with differential, peripheral blood smear findings, bone marrow biopsy results (if performed), any relevant medical history such as exposure to toxins, medications, radiation or chemotherapy, details regarding infectious diseases or chronic conditions, and a detailed description of the patient’s presenting signs and symptoms.

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