D72.825: Bandemia

The ICD-10-CM code for an elevated band neutrophil count on a CBC differential when the provider has not confirmed a specific infection to explain it.

Billable

FY2027

TABLE OF CONTENTS

Example H2

Medical scribe app interface showing a recording waveform, a list of patient notes, and a SOAP note for John Doe.

Stop looking up codes.

Scribe auto-generates them for you.

Try Commure Scribe →

At a glance

Code Family

D72.82: Elevated white blood cell count.

Condition

Bandemia

Billable

Yes, a single billable code with no child codes.

HCC Mapping (v28)

No mapping to any CMS-HCC v28 category.

Effective Date

Valid in the FY2026 code set and unchanged in the FY2027 update.

Family Specificity

Eight billable codes sit in the D72.82 subcategory, each naming a distinct white blood cell differential finding, with D72.825 reserved for elevated band neutrophils.

Which D72.82 code do I assign?

The D72.82 subcategory splits on which white blood cell population the differential reports as elevated. D72.825 is the band neutrophil entry and applies only while no specific infection has been confirmed.

When documentation says…

Code

Bands elevated on the CBC differential, no infection identified

D72.825

Bandemia recorded as a laboratory finding under evaluation. The note must show the elevated band count and a provider statement that no specific infection has been confirmed.

Elevated white blood cell count, cell line not specified

D72.829

Elevated white blood cell count, unspecified. Use this when the record documents leukocytosis without naming which cell line is raised.

Marked leukocytosis resembling leukemia

D72.823

Leukemoid reaction. The note must separate a marked reactive white cell elevation from an isolated band elevation and from a malignant process.

Increased basophils on the differential

D72.824

Basophilia. Use this when the differential identifies raised basophils rather than raised bands.

Infection confirmed, causative organism not identified

B99.9

Unspecified infectious disease. Once the provider documents a confirmed infection, the infection code replaces D72.825.

Sepsis confirmed at this encounter

A41.9

Sepsis, unspecified organism. The Excludes1 at D72.825 prohibits reporting bandemia alongside a confirmed infection.

Acute myeloblastic leukemia diagnosed

C92.00

Acute myeloblastic leukemia, not having achieved remission. Leukemia is an Excludes1 at D72.825. The leukemia code is assigned in its place.

Tabular notes

EXCLUDES1

Excludes1 at D72.825: confirmed infection, code to the infection. Leukemia, covering the C91.- through C95.- categories, is listed at the same code level. Excludes1 inherited from category D72: basophilia (D72.824), immunity disorders (D80–D89) and preleukemia (syndrome) (D46.9). Subcategory D72.8 carries an Excludes1 for leukemia (C91-C95). Subcategory D72.82 carries an Excludes1 for eosinophilia (D72.1). An Excludes1 note means the excluded condition and D72.825 are not reported together for the same condition. Where a specific infection is confirmed and documented, the infection code is assigned in place of D72.825.

EXCLUDES2

Category D72 carries an Excludes2 note for neutropenia (the D70 codes). D72.825 inherits that note from the category. Excludes2 means the patient may have both conditions. Bandemia and a D70 neutropenia code may be reported together when both are documented (Guideline I.A.12.b). The note permits both codes but does not require them.

FY2027: EFFECTIVE 1 OCTOBER 2026

The FY2027 codes and tabular addenda make no addition, deletion or revision in category D72. D72.825 is unchanged in the FY2027 update. The FY2027 tabular carries no Code First instruction and no Use Additional instruction at D72.825. The inclusion term at the code reads: bandemia without diagnosis of specific infection. That term is the operative clinical constraint on the code.

Operational & financial impact

Why specificity matters beyond the chart: risk adjustment, DRG assignment and denial exposure all follow from which code is selected.

CMS-HCC v28 (PY2024+)

D72.825 does not map to any category in CMS-HCC Model Version 28.

CMS-HCC v28 is fully operative at 100 percent weight for Medicare Advantage payment year 2026.

Reporting D72.825 contributes nothing to a beneficiary's risk score.

V24 TO V28 TRANSITION

D72.825 carried no HCC mapping under the prior CMS-HCC v24 model either.

Abnormal white blood cell count findings without a confirmed diagnosis sit outside the risk adjustment model in both versions. The move from v24 to v28 changes nothing for this code.

WHERE SPECIFICITY IS LOST

D72.829, elevated white blood cell count unspecified, records the leukocytosis without naming the band fraction. D72.825 records the specific finding the differential reports.

Neither code carries risk adjustment weight. The difference in specificity is clinical rather than financial.

The exposure that does carry cost is the Excludes1 at D72.825. Reporting bandemia alongside a confirmed infection conflicts with that note.

Medicare and commercial payers

There is no National Coverage Determination specific to D72.825.

D72.825 supports medical necessity documentation for a CBC with differential and for the infectious workup that follows when bandemia is the inciting finding.

Documentation checklist to support D72.825

Chart elements that support code selection and reduce specificity-driven denials.

A CBC with differential demonstrating an elevated band neutrophil count.

The band percentage as reported on the differential, because laboratory thresholds for bandemia vary.

Provider documentation naming the bandemia as a clinical finding under evaluation, rather than a laboratory value left unaddressed in the chart.

An explicit provider statement that no specific infection has been identified at the time of coding.

The workup prompted by the finding, such as further infectious testing.

Where bandemia is one of several findings under evaluation, the other presenting findings reported alongside it.

For a subsequent encounter, confirmation of whether an infection has since been diagnosed, which would replace D72.825 with the infection code.

FAQ

Is D72.825 a billable code?

Yes. D72.825 is a single billable code with no child codes. It is valid for reporting on a claim.

When do I use D72.825 instead of D72.829 or D72.823?

Use D72.825 when the differential identifies an elevated band neutrophil count. Use D72.829 when the record documents an elevated white blood cell count without naming which cell line is raised. Use D72.823 for a leukemoid reaction, a marked reactive white cell elevation that resembles leukemia.

Does D72.825 map to an HCC?

No. D72.825 has no mapping in CMS-HCC v28 or in the prior v24 model. Reporting it adds no weight to a beneficiary's risk score.

What must the note show to support D72.825?

The note must show three things: a CBC with differential showing elevated band neutrophils, provider documentation treating the bandemia as a finding under evaluation, and a statement that no specific infection has been confirmed. Laboratory values on their own are not sufficient under ICD-10-CM coding guidelines.

How is D72.825 sequenced?

Sequence D72.825 as the principal or primary diagnosis when bandemia without a confirmed infection is the reason for the encounter. Report it as an additional code when bandemia is one of several findings being evaluated.

Can I keep D72.825 once an infection is confirmed?

No. The Excludes1 at D72.825 prohibits it. Assign the infection code in place of D72.825, including at any later encounter once the infectious diagnosis is established.

Does D72.825 work differently for inpatient and outpatient encounters?

The code applies on the same terms in outpatient, urgent care, emergency department and inpatient settings. During an inpatient stay it may be reported while no specific infection has been confirmed. If an infection is identified before discharge, the infection code becomes the active diagnosis.

What changed for D72.825 in FY2027?

D72.825 is unchanged in the FY2027 update. The FY2027 update, effective 1 October 2026, makes no addition, deletion or revision in category D72.

Related codes

Codes in the same family as D72.825. Only codes with a published page render as links.

Sibling codes in the D72.82 family

D72.820: Lymphocytosis (symptomatic).
D72.821: Monocytosis (symptomatic).
D72.822: Plasmacytosis.
D72.823: Leukemoid reaction.
D72.824: Basophilia.
D72.828: Other elevated white blood cell count.
D72.829: Elevated white blood cell count, unspecified.

Additional codes to consider

Codes outside the D72.82 family considered alongside D72.825.

Consider instead

D72.829: Elevated white blood cell count, unspecified, where the raised cell line is not named.
D72.823: Leukemoid reaction, a marked reactive white cell elevation resembling leukemia.
D72.824: Basophilia, where the differential identifies raised basophils.
B99.9: Unspecified infectious disease, where an infection is confirmed but the organism is not identified.
A41.9: Sepsis, unspecified organism, where sepsis is the confirmed diagnosis.
C92.00: Acute myeloblastic leukemia, not having achieved remission, where leukemia is diagnosed.
D46.9: Myelodysplastic syndrome, unspecified, an Excludes1 inherited from category D72.
D70.9: Neutropenia, unspecified, where the neutrophil count is low rather than showing an elevated band fraction.

Sources

All claims on this page derive from government and professional-standards sources.

National Center for Health Statistics. (2026). International classification of diseases, tenth revision, clinical modification (ICD-10-CM) FY2027 files. https://www.cdc.gov/nchs/icd/icd-10-cm/files.html
Centers for Medicare & Medicaid Services and National Center for Health Statistics. (2026). ICD-10-CM official guidelines for coding and reporting FY2027. https://ftp.cdc.gov/pub/Health_Statistics/NCHS/Publications/ICD10CM/2027/ICD-10-CM-October-1-2026-FY27-Guidelines.pdf
Centers for Medicare & Medicaid Services. (2025). 2026 model software/ICD-10 mappings. https://www.cms.gov/medicare/payment/medicare-advantage-rates-statistics/risk-adjustment/2026-model-software-icd-10-mappings
Centers for Medicare & Medicaid Services. (2026). MS-DRG classifications and software, version 44. https://www.cms.gov/medicare/payment/prospective-payment-systems/acute-inpatient-pps/ms-drg-classifications-and-software