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ICD-10 Guide
ICD-10 CodesD52.9

D52.9

Billable

Folate deficiency anemia, unspecified

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

Code Description

ICD-10 D52.9 is a billable code used to indicate a diagnosis of folate deficiency anemia, unspecified.

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 can lead to the production of abnormally large red blood cells (macrocytes) that are ineffective in transporting oxygen. Symptoms may include fatigue, weakness, pallor, and shortness of breath. Folate deficiency can arise from inadequate dietary intake, malabsorption syndromes, increased demand during pregnancy or lactation, and certain medications that interfere with folate metabolism. Diagnosis typically involves blood tests showing low serum folate levels and macrocytic anemia. Treatment primarily focuses on folate supplementation, dietary modifications to include folate-rich foods (such as leafy greens, legumes, and fortified cereals), and addressing any underlying causes of the deficiency. Regular monitoring of hemoglobin levels and folate status is essential to ensure effective management of the condition.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between types of anemia (iron deficiency vs. folate deficiency)
  • Understanding dietary sources and absorption issues related to folate
  • Recognizing the impact of medications on folate metabolism
  • Identifying coexisting conditions that may complicate diagnosis

Audit Risk Factors

  • Inadequate documentation of dietary history
  • Failure to document the specific type of anemia
  • Lack of follow-up on treatment efficacy
  • Misclassification of anemia type

Specialty Focus

Medical Specialties

Hematology

Documentation Requirements

Detailed lab results, patient history, and treatment plans must be documented.

Common Clinical Scenarios

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

Billing Considerations

Ensure that all lab tests are clearly linked to the diagnosis of folate deficiency anemia.

Nutrition

Documentation Requirements

Comprehensive dietary assessments and recommendations for folate-rich foods.

Common Clinical Scenarios

Patients with dietary restrictions or malabsorption syndromes.

Billing Considerations

Documenting the patient's dietary intake and any supplements taken is crucial.

Coding Guidelines

Inclusion Criteria

Use D52.9 When
  • Follow the official ICD
  • CM coding guidelines for anemia, ensuring accurate documentation of the type of anemia and any underlying causes

Exclusion Criteria

Do NOT use D52.9 When
  • Exclude codes for other specific types of anemia unless they are coexisting conditions

Related ICD-10 Codes

Related CPT Codes

85025CPT Code

Complete blood count (CBC) with automated 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 linked to the diagnosis.

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 diagnoses and treatment tracking. It has also facilitated better data collection for public health monitoring.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of folate deficiency anemia, improving the accuracy of diagnoses and treatment tracking. It has also facilitated better data collection for public health monitoring.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of folate deficiency anemia, improving the accuracy of diagnoses and treatment tracking. It has also facilitated better data collection for public health monitoring.

Resources

Clinical References

  • •
    CDC - Folate Deficiency

Coding & Billing References

  • •
    CDC - Folate Deficiency

Frequently Asked Questions

What are the common causes of folate deficiency anemia?

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

How is folate deficiency anemia diagnosed?

Diagnosis is typically made through blood tests showing low serum folate levels and macrocytic anemia, along with a thorough patient history and dietary assessment.