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ICD-10 Guide
ICD-10 CodesD53.0

D53.0

Billable

Protein deficiency anemia

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

Code Description

ICD-10 D53.0 is a billable code used to indicate a diagnosis of protein deficiency anemia.

Key Diagnostic Point:

Protein deficiency anemia is a type of anemia that occurs due to inadequate protein intake, leading to insufficient production of hemoglobin and red blood cells. This condition is often seen in individuals with malnutrition, chronic illnesses, or specific dietary restrictions. Protein is essential for the synthesis of hemoglobin, and its deficiency can result in a decrease in red blood cell production, leading to symptoms such as fatigue, weakness, pallor, and shortness of breath. The condition can be exacerbated by other nutritional deficiencies, such as iron, vitamin B12, and folate, which are crucial for red blood cell formation. Diagnosis typically involves a complete blood count (CBC) to assess hemoglobin levels and red blood cell indices, along with dietary assessments to evaluate protein intake. Treatment focuses on dietary modifications to increase protein consumption, supplementation if necessary, and addressing any underlying conditions contributing to malnutrition. Regular monitoring of hemoglobin levels and nutritional 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 (e.g., iron deficiency vs. protein deficiency)
  • Need for comprehensive dietary assessment
  • Potential overlap with other nutritional deficiencies
  • Documentation of underlying causes and contributing factors

Audit Risk Factors

  • Inadequate documentation of dietary intake
  • Failure to document underlying conditions contributing to anemia
  • Misclassification of anemia type
  • Lack of follow-up on treatment efficacy

Specialty Focus

Medical Specialties

Nutrition

Documentation Requirements

Detailed dietary assessments and patient history regarding protein intake.

Common Clinical Scenarios

Patients with malnutrition, chronic illness, or restrictive diets.

Billing Considerations

Ensure comprehensive documentation of dietary habits and any supplementation.

Hematology

Documentation Requirements

Complete blood count results, iron studies, and vitamin levels.

Common Clinical Scenarios

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

Billing Considerations

Document all lab results and clinical findings to support diagnosis.

Coding Guidelines

Inclusion Criteria

Use D53.0 When
  • According to ICD
  • 10 coding guidelines, D53
  • 0 should be used when protein deficiency is the primary cause of anemia
  • It is important to document the specific dietary deficiencies and any related conditions

Exclusion Criteria

Do NOT use D53.0 When
  • Exclusion criteria include anemia due to other nutritional deficiencies that should be coded separately

Related ICD-10 Codes

Related CPT Codes

85025CPT Code

Complete blood count (CBC) with automated differential

Clinical Scenario

Used to evaluate anemia and monitor hemoglobin levels.

Documentation Requirements

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

Specialty Considerations

Hematology specialists should ensure all lab results are included in the patient's record.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of nutritional anemias, including protein deficiency anemia, which enhances the ability to track and manage these conditions effectively.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of nutritional anemias, including protein deficiency anemia, which enhances the ability to track and manage these conditions effectively.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of nutritional anemias, including protein deficiency anemia, which enhances the ability to track and manage these conditions effectively.

Resources

Clinical References

  • •
    Nutritional Anemia: A Guide for Clinicians

Coding & Billing References

  • •
    Nutritional Anemia: A Guide for Clinicians

Frequently Asked Questions

What are the common causes of protein deficiency anemia?

Common causes include inadequate dietary protein intake, malabsorption syndromes, chronic illnesses, and restrictive diets. It is essential to assess the patient's dietary history and any underlying health conditions.