Coding Anemia
Anemia occurs when the patient does not have enough red blood cells or does not have enough hemoglobin to carry oxygen to the body’s tissues. There are many different types of anemia. The most common are iron deficiency anemia, vitamin B12 deficiency, and folic acid deficiency. When we are coding anemia, we will begin with the main term ‘Anemia’ in the ICD-10-CM Alphabetic Index, then we will look for the sub-term that identifies the type or cause of the anemia.
Anemia can also be caused by other diseases. It is important to remember that there are coding guidelines for the proper code selection and sequencing when a patient develops anemia because of neoplastic disease, chemotherapy, or radiotherapy. Management of anemia in neoplastic disease is coded with the appropriate primary code to identify the neoplasm and D63.0 as an additional code for the anemia. If the anemia is caused by chemotherapy and the treatment is focused on the anemia, the anemia is coded first, followed by a code for the neoplasm and then for adverse effect of antineoplastic chemotherapy.
When anemia is associated with chronic kidney disease, the code for the chronic kidney diseases is reported first, followed by the code for the anemia.
Q: In referencing the ICD-10-CM guideline I.A.13, when using a code from category D63 it is also necessary to code first:
A: The chronic condition causing the anemia. Rationale: The ICD-10-CM coding guideline I.A.13., states when using a code from a category that indicates “in diseases classified elsewhere,” such as in category D63, it is necessary to code first the chronic condition (underlying condition) causing the anemia. The codes from category D63 are manifestation codes that must be reported as the additional code following the underlying condition.
Reference: 2024 ICD-10-CM codebook & guidelines, Mayo Clinic
