ICD Code D61.818

ICD code D61.818 is used to identify a condition known as "Other pancytopenia." Pancytopenia refers to a medical condition characterized by the reduction of all three types of blood cells: red blood cells, white blood cells, and platelets. This code is specifically used when the pancytopenia does not fit into more specific categories or causes listed elsewhere in the ICD coding system. It is important for healthcare providers to accurately document this condition for proper diagnosis, treatment planning, and billing purposes.

When considering the use of the ICD code for "Other pancytopenia," healthcare providers should evaluate the following diagnostic criteria and symptoms:

1. Complete Blood Count (CBC) Results:

- Presence of reduced levels of all three blood cell types: red blood cells, white blood cells, and platelets.

2. Anemia Symptoms:

- Fatigue

- Weakness

- Pallor (pale skin)

3. Leukopenia Symptoms:

- Increased susceptibility to infections

- Frequent or severe infections

4. Thrombocytopenia Symptoms:

- Easy or excessive bruising

- Prolonged bleeding from cuts

- Spontaneous bleeding (e.g., nosebleeds, bleeding gums)

5. Bone Marrow Examination:

- Hypocellular or aplastic bone marrow findings, ruling out other specific causes of pancytopenia.

6. Exclusion of Other Causes:

- Rule out specific conditions such as aplastic anemia, myelodysplastic syndromes, or other hematological disorders that have distinct ICD codes.

7. Patient History and Physical Examination:

- Comprehensive review of medical history, including medication use, exposure to toxins, or recent viral infections that could contribute to pancytopenia.

8. Additional Laboratory Tests:

- Reticulocyte count to assess bone marrow response.

- Peripheral blood smear to evaluate the morphology of blood cells.

By systematically evaluating these criteria, healthcare providers can determine the appropriateness of using this specific ICD code in the context of a patient's clinical presentation.

For the ICD code D61.818 (Other pancytopenia), the relevant CPT codes that may be applicable for treatment or management include:

1. 85025 - Complete blood count (CBC) with automated differential white blood cell count.

2. 85027 - Complete blood count (CBC), automated (Hgb, Hct, RBC, WBC, and platelet count).

3. 85007 - Blood count; blood smear, microscopic examination with manual differential WBC count.

4. 38220 - Bone marrow aspiration only.

5. 38221 - Bone marrow biopsy, needle or trocar.

6. 36415 - Collection of venous blood by venipuncture.

7. 96365 - Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour.

8. 96366 - Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour.

These CPT codes are commonly associated with diagnostic and treatment procedures for conditions related to pancytopenia. It is important for healthcare providers to verify the specific services rendered and ensure accurate coding based on the individual patient's treatment plan.

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