ICD-10-CM 2027
ICD-10 code for congenital anemia
Other congenital anemias, not elsewhere classified
From the official ICD-10-CM alphabetic index entry “Anemia (essential) (general) (hemoglobin deficiency) (infantile) (primary) (profound) › congenital”. Page updated September 29, 2026.
About coding congenital anemia
The ICD-10-CM code for congenital anemia is P61.4 (Other congenital anemias, not elsewhere classified). The official index lists 8 more specific codes, so check the documentation for details such as type, cause, site or severity before settling on P61.4.
Within P61, choose P61.4 (Other congenital anemias, not elsewhere classified) only when documentation doesn't support a more specific option: transient neonatal thrombocytopenia (P61.0), polycythemia neonatorum (P61.1), anemia of prematurity (P61.2), congenital anemia from fetal blood loss (P61.3), transient neonatal neutropenia (P61.5), other transient neonatal disorders of coagulation (P61.6), other specified perinatal hematological disorders (P61.8) and perinatal hematological disorder, unspecified (P61.9).
As a secondary diagnosis it is a CC (complication or comorbidity), which can move an inpatient stay into the "with CC" MS-DRG of its family, unless the principal diagnosis excludes it.
In MS-DRG v44.0, it is part of the grouping logic for DRG 794 (Neonate with Other Significant Problems, relative weight 1.4935), in MDC 15 (Newborns and Other Neonates with Conditions Originating in the Perinatal Period), as a principal or secondary diagnosis. The DRG a claim lands in depends on the principal diagnosis, procedures and any CC/MCC secondary diagnoses.
More specific congenital anemia codes (official index)
- aplastic D61.09 — Other constitutional aplastic anemia
- due to isoimmunization NOS P55.9 — Hemolytic disease of newborn, unspecified
- dyserythropoietic, dyshematopoietic D64.4 — Congenital dyserythropoietic anemia
- following fetal blood loss P61.3 — Congenital anemia from fetal blood loss
- Heinz body D58.2 — Other hemoglobinopathies
- hereditary hemolytic NOS D58.9 — Hereditary hemolytic anemia, unspecified
- pernicious D51.0 — Vitamin B12 deficiency anemia due to intrinsic factor deficiency
- spherocytic D58.0 — Hereditary spherocytosis
Common questions about congenital anemia ICD-10 codes
What is the ICD-10 code for congenital anemia?
- P61.4 — Other congenital anemias, not elsewhere classified. More specific codes apply when the documentation supports them: D61.09, P55.9, D64.4, P61.3 and others below.
What is the ICD-10 code for aplastic congenital anemia?
- D61.09 — Other constitutional aplastic anemia.
What is the ICD-10 code for heinz body congenital anemia?
- D58.2 — Other hemoglobinopathies.
What is the ICD-10 code for hereditary hemolytic nos congenital anemia?
- D58.9 — Hereditary hemolytic anemia, unspecified.
What is the ICD-10 code for pernicious congenital anemia?
- D51.0 — Vitamin B12 deficiency anemia due to intrinsic factor deficiency.
What is the ICD-10 code for spherocytic congenital anemia?
- D58.0 — Hereditary spherocytosis.
Is P61.4 billable?
- Yes. P61.4 is a billable/specific ICD-10-CM code valid for FY2027 (October 1, 2026 – September 30, 2027).
Can P61.4 be used as a principal diagnosis?
- Yes. The Medicare Code Editor doesn't restrict P61.4 as a principal diagnosis.
Is P61.4 a CC or MCC?
- P61.4 is a CC (complication or comorbidity) under MS-DRG v44.0, unless excluded by the principal diagnosis.