ICD-10 Logo
ICDxICD-10 Medical Coding
ICD-10 Logo
ICDxICD-10 Medical Coding
ICD 10 CodesDiagnoses
ICD 10 CodesDiagnoses
ICD-10 Logo
ICDxICD-10 Medical Coding

Comprehensive ICD-10-CM code reference with AI-powered search capabilities.

© 2025 ICD Code Compass. All rights reserved.

Browse

  • All Chapters
  • All Categories
  • Diagnoses

Tools

  • AI Code Search
ICD-10-CM codes are maintained by the CDC and CMS. This tool is for reference purposes only.
v1.0.0
ICD-10 Guide
DiagnosesAnemia Esrd

Anemia Esrd

ICD-10 Coding for Anemia in End-Stage Renal Disease(N18.6, D63.1)

PRIMARY SPECIALTYNephrology
COMPLEXITYHigh
LAST UPDATED09/15/2025
Sam Tuffun, PT, DPT
Physical Therapist | Medical Coding & Billing Contributor

Diagnosis Overview

What is Anemia Esrd?
Essential facts and insights about Anemia in End-Stage Renal Disease

Key Clinical Considerations:

  • Presence of fatigue, weakness, pallor, and shortness of breath.
  • Laboratory findings include low hemoglobin levels (typically < 12 g/dL for women and < 13 g/dL for men) and low hematocrit.
  • Physical examination may reveal signs of anemia such as pale conjunctiva, tachycardia, or hypotension.
  • Imaging or procedural findings are generally not applicable for anemia diagnosis but may include ultrasound or CT scans to assess kidney function.
  • Severity criteria include classification of anemia as mild, moderate, or severe based on hemoglobin levels and associated symptoms.

Clinical Information

Clinical Criteria & Documentation Requirements

  • Medical records must document the diagnosis of anemia in the context of end-stage renal disease (ESRD).
  • Specific terminology such as 'anemia due to chronic kidney disease' or 'anemia secondary to ESRD' must be used.
  • Examples include: 'Patient diagnosed with anemia secondary to ESRD, confirmed by hemoglobin levels of 10 g/dL.'
  • Medical necessity documentation should include rationale for anemia treatment in ESRD patients, such as erythropoiesis-stimulating agents.
  • Quality measure documentation needs to include monitoring of hemoglobin levels and treatment response.

Coding Guidelines

Usage Guidelines & Examples

  • Use this diagnosis code when the patient has documented anemia specifically related to ESRD.
  • Do NOT use this code for anemia due to other causes such as iron deficiency or vitamin B12 deficiency without ESRD.
  • Related codes include D63.0 (Anemia in chronic disease) and N18.6 (End-stage renal disease), which may be used in conjunction.
  • Common coding errors include failing to document the relationship between anemia and ESRD; ensure clear linkage in medical records.
  • In complex cases, consider additional codes for underlying causes of anemia if applicable.

Code Exclusions

Important Exclusions

  • Excluded conditions include anemia due to acute blood loss or hemolytic anemia.
  • Alternative codes for excluded conditions include D50 for iron deficiency anemia unrelated to ESRD.
  • Conditions are excluded because they have distinct etiologies and treatment protocols.
  • Common exclusion mistakes include misclassifying anemia due to acute causes as chronic.
  • Related but distinct conditions include anemia of chronic disease not related to kidney function.

Related ICD-10 Codes

Primary Codes
N18.6
End-stage renal disease
D63.1
Anemia in chronic kidney disease
Ancillary Codes
Z99.2
Differential Codes
D64.9
D63.1
when anemia is specified as due to CKD.

Related CPT Codes

CPT codes will be available in a future update.

Specialty Focus

Primary Specialty

Nephrology

Specialty Applications

  • This applies to patients diagnosed with end-stage renal disease experiencing anemia.
  • Patient populations include adults and elderly patients, particularly those with chronic kidney disease risk factors.
  • Clinical settings include nephrology clinics, dialysis centers, and inpatient hospital settings.
  • Specialty-specific applications are relevant in nephrology and hematology.
  • Treatment contexts include management of anemia with erythropoiesis-stimulating agents and iron supplementation.

Coding Complexity

High Complexity

This diagnosis requires careful attention to:

  • Comprehensive clinical documentation
  • Accurate code selection based on clinical criteria
  • Proper exclusion considerations
  • Specialty-specific coding guidelines

Documentation

Documentation Templates

Template 1

Template: 'Patient diagnosed with anemia due to ESRD based on hemoglobin levels of [value].'

Template 2

Template: 'Clinical presentation consistent with anemia including fatigue and pallor.'

Template 3

Template: 'Diagnostic criteria for anemia met as evidenced by hemoglobin of [value] and hematocrit of [value].'

Template 4

Template: 'Treatment plan initiated for anemia with erythropoiesis-stimulating agents and iron supplementation.'

Template 5

Template: 'Follow-up care for anemia in ESRD including monitoring hemoglobin levels every [time frame].'

Billing Information

Billing Considerations

  • Ensure proper documentation for billing
  • Verify code specificity requirements
  • Check for any additional codes needed
  • Review payer-specific guidelines

Common Issues

  • Insufficient clinical documentation
  • Incorrect code selection
  • Missing supporting diagnoses
  • Timing and frequency documentation

Frequently Asked Questions

What documentation is required for this diagnosis?

Documentation must include hemoglobin levels, symptoms, and the relationship to ESRD.

How does this differ from similar diagnoses?

Anemia in ESRD is specifically related to kidney function, unlike other anemias which may have different causes.

What are common billing considerations?

Ensure that the diagnosis is clearly linked to the treatment provided to optimize reimbursement.

What procedures are typically associated?

CPT codes for procedures may include dialysis and administration of erythropoiesis-stimulating agents.

Are there any quality reporting implications?

Quality measures may include monitoring hemoglobin levels and treatment effectiveness in ESRD patients.