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v1.0.0
ICD-10 Guide
ICD-10 CodesD63.1

D63.1

Billable

Anemia in chronic kidney disease

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

Code Description

ICD-10 D63.1 is a billable code used to indicate a diagnosis of anemia in chronic kidney disease.

Key Diagnostic Point:

Anemia in chronic kidney disease (CKD) is a common complication that arises due to the kidneys' diminished ability to produce erythropoietin, a hormone crucial for red blood cell production. Patients with CKD often experience a reduction in red blood cell count, leading to symptoms such as fatigue, weakness, and pallor. The anemia associated with CKD is typically normocytic and normochromic, although it can also present as microcytic in some cases due to concurrent iron deficiency. The pathophysiology involves a combination of factors including decreased erythropoietin production, iron deficiency, and the effects of uremia on bone marrow function. Management of anemia in CKD often includes erythropoiesis-stimulating agents (ESAs) and iron supplementation, tailored to the patient's specific needs and underlying conditions. It is crucial for healthcare providers to monitor hemoglobin levels and iron status regularly to optimize treatment and improve patient outcomes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between anemia due to CKD and other types of anemia.
  • Understanding the interplay between CKD and iron metabolism.
  • Documenting the severity and etiology of anemia accurately.
  • Navigating the guidelines for the use of ESAs and iron therapy.

Audit Risk Factors

  • Inadequate documentation of CKD stage.
  • Failure to document the type of anemia.
  • Lack of evidence for treatment decisions (e.g., ESA use).
  • Inconsistent hemoglobin level reporting.

Specialty Focus

Medical Specialties

Nephrology

Documentation Requirements

Detailed documentation of kidney function, CKD stage, and anemia workup.

Common Clinical Scenarios

Patients with advanced CKD presenting with fatigue and low hemoglobin levels.

Billing Considerations

Monitoring for iron deficiency and response to ESA therapy.

Hematology

Documentation Requirements

Comprehensive evaluation of anemia type and underlying causes.

Common Clinical Scenarios

Patients with CKD referred for anemia management and treatment options.

Billing Considerations

Differentiating between CKD-related anemia and other hematologic disorders.

Coding Guidelines

Inclusion Criteria

Use D63.1 When
  • According to ICD
  • 10 guidelines, D63
  • 1 should be used when anemia is specifically due to chronic kidney disease
  • It is important to document the stage of CKD and any treatments being administered

Exclusion Criteria

Do NOT use D63.1 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

36415CPT Code

Collection of venous blood by venipuncture

Clinical Scenario

Used for routine hemoglobin level checks in CKD patients.

Documentation Requirements

Document the reason for blood draw and patient history.

Specialty Considerations

Nephrologists should ensure that lab results are linked to CKD management.

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 chronic kidney disease, improving the accuracy of patient records and treatment plans.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of anemia related to chronic kidney disease, improving the accuracy of patient records and treatment plans.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of anemia related to chronic kidney disease, improving the accuracy of patient records and treatment plans.

Resources

Clinical References

  • •
    Kidney Disease: Improving Global Outcomes (KDIGO)

Coding & Billing References

  • •
    Kidney Disease: Improving Global Outcomes (KDIGO)

Frequently Asked Questions

What is the primary cause of anemia in chronic kidney disease?

The primary cause of anemia in CKD is the reduced production of erythropoietin by the kidneys, leading to decreased red blood cell production.