ICDcodes.org
FY2027

P61.4 — Other congenital anemias, not elsewhere classified

BillableUnspecifiedCC

Is P61.4 billable?

Yes, but P61.4 is an unspecified code. P61.4 is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, P61.4 is an unspecified or catch-all code. Payers apply additional scrutiny to unspecified codes and many deny them when the medical record supports a more specific option, so check the documentation before selecting P61.4 — the more specific alternatives are listed below.

P61.4 at a glance

CodeP61.4
DescriptionOther congenital anemias, not elsewhere classified
BillableYes
Code setICD-10-CM FY2027
Valid for encountersOctober 1, 2026 – September 30, 2027

Which MS-DRGs does P61.4 group to?

P61.4 sits in MDC 15 and helps define the logic of 1 MS-DRG (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.

  • 794Neonate with Other Significant Problemsmedical

As a secondary diagnosis, P61.4 is a complication or comorbidity (CC), which can move a stay into a higher-paying DRG.

How is P61.4 listed in the Alphabetic Index?

These are the routes through the Alphabetic Index that lead to P61.4. They show the wording a clinician may have documented, which often differs from the Tabular description.

  • Anemia › congenital (essential) (general) (hemoglobin deficiency) (infantile) (primary) (profound)
  • Anemia › newborn (essential) (general) (hemoglobin deficiency) (infantile) (primary) (profound)

Inclusion terms

Alternative wording in documentation that is classified to P61.4.

  • Congenital anemia NOS

Excludes1 — never code together — inherited from P50-P61

The conditions below can never be reported together with P61.4 on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.

  • congenital stenosis and stricture of bile ducts (Q44.3)
  • Crigler-Najjar syndrome (E80.5)
  • Dubin-Johnson syndrome (E80.6)
  • Gilbert syndrome (E80.4)
  • hereditary hemolytic anemias (D55-D58)

Excludes1 — never code together — inherited from P61

The conditions below can never be reported together with P61.4 on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.

  • transient hypogammaglobulinemia of infancy (D80.7)

Excludes2 — not included here — inherited from Chapter 16

The conditions below are not part of P61.4, but a patient may have both at the same time. When documentation supports it, P61.4 and the excluded code may both be reported.

  • congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)
  • endocrine, nutritional and metabolic diseases (E00-E88)
  • injury, poisoning and certain other consequences of external causes (S00-T88)
  • neoplasms (C00-D49)
  • tetanus neonatorum (A33)

How long has P61.4 existed?

P61.4 has been in ICD-10-CM since at least FY2016, the earliest fiscal year on record here.

Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.

Which codes are confused with P61.4?

ICD-10-CM declares these codes mutually exclusive with P61.4 — exactly one of each pair can be correct for a given encounter.

Which conditions are coded to P61.4?

What other codes are in the P61 family? (8)