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ICD-10 Guide
ICD-10 CodesD63.0

D63.0

Billable

Anemia in neoplastic disease

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

Code Description

ICD-10 D63.0 is a billable code used to indicate a diagnosis of anemia in neoplastic disease.

Key Diagnostic Point:

Anemia in neoplastic disease refers to a type of anemia that occurs as a consequence of malignancies. This condition can arise from various mechanisms, including bone marrow infiltration by neoplastic cells, chronic disease processes, or treatment-related effects such as chemotherapy or radiation. Aplastic anemia, a severe form of bone marrow failure, can also be associated with neoplastic diseases, leading to a significant reduction in red blood cell production. The acquired anemias linked to neoplastic diseases often present with symptoms such as fatigue, pallor, and weakness, which can significantly impact the patient's quality of life. The diagnosis of anemia in this context requires careful evaluation of the patient's medical history, laboratory tests including complete blood counts, and possibly bone marrow biopsies to determine the underlying cause. Management may involve treating the underlying malignancy, blood transfusions, or the use of erythropoiesis-stimulating agents. Accurate coding is essential for appropriate treatment and reimbursement.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between types of anemia and their causes
  • Understanding the relationship between neoplastic diseases and anemia
  • Documentation requirements for underlying malignancies
  • Variability in clinical presentation and laboratory findings

Audit Risk Factors

  • Inadequate documentation of the underlying neoplastic disease
  • Failure to specify the type of anemia
  • Misclassification of anemia type
  • Lack of supporting lab results

Specialty Focus

Medical Specialties

Hematology/Oncology

Documentation Requirements

Detailed documentation of the patient's cancer diagnosis, treatment history, and laboratory results related to anemia.

Common Clinical Scenarios

Patients undergoing chemotherapy who develop anemia, or those with bone marrow involvement from malignancies.

Billing Considerations

Ensure that the relationship between the neoplastic disease and anemia is clearly documented to support coding.

Internal Medicine

Documentation Requirements

Comprehensive patient history, including chronic diseases and medications that may contribute to anemia.

Common Clinical Scenarios

Management of patients with chronic illnesses and anemia, particularly in the context of cancer.

Billing Considerations

Documenting the severity of anemia and its impact on the patient's overall health is crucial.

Coding Guidelines

Inclusion Criteria

Use D63.0 When
  • According to ICD
  • 10 coding guidelines, D63
  • 0 should be used when anemia is directly related to a neoplastic disease
  • Coders must ensure that the underlying malignancy is documented and coded appropriately

Exclusion Criteria

Do NOT use D63.0 When
  • Exclusion criteria include anemia not related to neoplastic disease

Related ICD-10 Codes

Related CPT Codes

36415CPT Code

Collection of venous blood by venipuncture

Clinical Scenario

Used when obtaining blood samples for anemia evaluation.

Documentation Requirements

Document the reason for blood draw and any relevant clinical findings.

Specialty Considerations

Ensure that the blood draw is linked to the anemia diagnosis.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of anemia related to neoplastic diseases, improving the accuracy of patient records and reimbursement processes. It emphasizes the importance of documenting the relationship between anemia and malignancies.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of anemia related to neoplastic diseases, improving the accuracy of patient records and reimbursement processes. It emphasizes the importance of documenting the relationship between anemia and malignancies.

Reimbursement & Billing Impact

reimbursement processes. It emphasizes the importance of documenting the relationship between anemia and malignancies.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What is the primary cause of anemia in neoplastic disease?

Anemia in neoplastic disease is primarily caused by bone marrow infiltration by cancer cells, leading to decreased red blood cell production, as well as treatment-related effects such as chemotherapy.