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ICD-10 Guide
ICD-10 CodesChapter 3: Diseases of the blood and blood-forming organsD52

D52

Billable

Folate deficiency anemia

Chapter 3:Diseases of the blood and blood-forming organs

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/05/2025

Code Description

ICD-10 D52 is a billable code used to indicate a diagnosis of folate deficiency anemia.

Key Diagnostic Point:

Folate deficiency anemia is a type of megaloblastic anemia characterized by a deficiency of folate (vitamin B9), which is essential for DNA synthesis and red blood cell production. This condition leads to the production of abnormally large red blood cells that are ineffective in transporting oxygen. Folate deficiency can arise from inadequate dietary intake, malabsorption syndromes, increased demand during pregnancy or lactation, and certain medications that interfere with folate metabolism. Symptoms may include fatigue, weakness, pallor, and shortness of breath. Diagnosis typically involves blood tests showing low serum folate levels and macrocytic anemia. Treatment focuses on dietary modification to include folate-rich foods, such as leafy greens, legumes, and fortified cereals, along with oral or injectable folate supplements. Monitoring of hemoglobin levels and reticulocyte counts is essential to assess the response to treatment and ensure resolution of anemia.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between folate deficiency and other types of anemia, such as iron deficiency or vitamin B12 deficiency.
  • Understanding the various causes of folate deficiency, including dietary, malabsorption, and drug-induced factors.
  • The need for comprehensive documentation of dietary habits and medical history to support the diagnosis.
  • Potential overlap with other ICD-10 codes related to anemia, requiring careful coding to avoid errors.

Audit Risk Factors

  • Inadequate documentation of dietary intake and medical history.
  • Failure to document the specific type of anemia being treated.
  • Lack of follow-up documentation to confirm treatment response.
  • Misclassification of anemia type leading to incorrect coding.

Specialty Focus

Medical Specialties

Hematology

Documentation Requirements

Detailed blood work results, including complete blood count (CBC) and serum folate levels.

Common Clinical Scenarios

Patients presenting with fatigue and pallor, requiring differential diagnosis of anemia types.

Billing Considerations

Ensure that all laboratory results are clearly documented and correlate with clinical findings.

Nutrition

Documentation Requirements

Comprehensive dietary assessments and recommendations for folate-rich foods.

Common Clinical Scenarios

Patients with dietary restrictions or malabsorption syndromes requiring nutritional intervention.

Billing Considerations

Documenting the patient's dietary habits and any supplements taken to support the diagnosis.

Coding Guidelines

Inclusion Criteria

Use D52 When
  • According to ICD
  • 10 guidelines, D52 should be used when the anemia is specifically due to folate deficiency
  • It is important to document the cause of the deficiency, whether it is dietary, malabsorption, or related to medication use

Exclusion Criteria

Do NOT use D52 When
  • Exclusion criteria include other types of anemia that do not involve folate deficiency

Related CPT Codes

85025CPT Code

Complete blood count (CBC) with differential

Clinical Scenario

Used to evaluate anemia and monitor treatment response.

Documentation Requirements

Document the reason for the CBC and any relevant clinical findings.

Specialty Considerations

Hematology specialists should ensure all lab results are correlated with clinical symptoms.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of folate deficiency anemia, improving the accuracy of diagnosis and treatment tracking. This specificity aids in better patient management and resource allocation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of folate deficiency anemia, improving the accuracy of diagnosis and treatment tracking. This specificity aids in better patient management and resource allocation.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of folate deficiency anemia, improving the accuracy of diagnosis and treatment tracking. This specificity aids in better patient management and resource allocation.

Resources

Clinical References

  • •
    CDC - Folate Deficiency Anemia

Coding & Billing References

  • •
    CDC - Folate Deficiency Anemia

Frequently Asked Questions

What are the common causes of folate deficiency anemia?

Common causes include inadequate dietary intake, malabsorption syndromes, increased physiological demands during pregnancy, and certain medications that interfere with folate metabolism.

How is folate deficiency anemia treated?

Treatment typically involves dietary modifications to include folate-rich foods and supplementation with folate, either orally or via injection, depending on the severity of the deficiency.