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ICD-10 Guide
ICD-10 CodesChapter 3: Diseases of the blood and blood-forming organsD64

D64

Billable

Other anemias

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

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

Code Description

ICD-10 D64 is a billable code used to indicate a diagnosis of other anemias.

Key Diagnostic Point:

D64 encompasses a variety of anemias that do not fall under more specific categories. This includes aplastic anemia, which is characterized by the failure of the bone marrow to produce adequate blood cells, leading to a deficiency in red blood cells, white blood cells, and platelets. Aplastic anemia can be acquired due to factors such as exposure to toxins, certain medications, or viral infections. Bone marrow failure syndromes, which may present similarly, can also be classified under this code. Other acquired anemias, such as those resulting from chronic diseases, nutritional deficiencies, or hemolytic processes, are included as well. Hematopoietic disorders, which affect blood cell production and function, may also lead to anemias categorized under D64. Accurate diagnosis and documentation are crucial, as the underlying causes can significantly influence treatment and management strategies. Clinicians must provide comprehensive details regarding the etiology and clinical presentation to ensure appropriate coding and reimbursement.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of underlying causes leading to anemia
  • Need for detailed clinical documentation to specify type of anemia
  • Differentiation from other anemia codes
  • Potential for overlapping symptoms with other hematologic disorders

Audit Risk Factors

  • Insufficient documentation of the underlying cause of anemia
  • Failure to specify the type of anemia when applicable
  • Inconsistent coding practices among different providers
  • Lack of clarity in clinical notes regarding treatment plans

Specialty Focus

Medical Specialties

Hematology

Documentation Requirements

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

Common Clinical Scenarios

Patients presenting with unexplained fatigue, recurrent infections, or bleeding tendencies.

Billing Considerations

Hematologists should ensure that the etiology of anemia is clearly stated to avoid ambiguity in coding.

Primary Care

Documentation Requirements

Comprehensive patient history and physical examination findings are essential.

Common Clinical Scenarios

Routine screening for anemia in patients with chronic diseases or nutritional deficiencies.

Billing Considerations

Primary care providers should document any referrals to specialists for further evaluation.

Coding Guidelines

Inclusion Criteria

Use D64 When
  • According to ICD
  • 10 guidelines, D64 should be used when the specific type of anemia is not classified elsewhere
  • Coders must ensure that the documentation supports the diagnosis and that any underlying conditions are also coded appropriately

Exclusion Criteria

Do NOT use D64 When
No specific exclusions found.

Related CPT Codes

85025CPT Code

Complete blood count (CBC) with differential

Clinical Scenario

Used to evaluate anemia severity and type.

Documentation Requirements

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

Specialty Considerations

Hematologists may require additional tests based on initial CBC results.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of anemias, improving the ability to capture the nuances of different types of anemia. D64 serves as a catch-all for various anemias that do not fit into more defined categories, emphasizing the need for precise documentation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of anemias, improving the ability to capture the nuances of different types of anemia. D64 serves as a catch-all for various anemias that do not fit into more defined categories, emphasizing the need for precise documentation.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of anemias, improving the ability to capture the nuances of different types of anemia. D64 serves as a catch-all for various anemias that do not fit into more defined categories, emphasizing the need for precise documentation.

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 types of anemia are included under D64?

D64 includes various anemias such as aplastic anemia, anemia due to chronic disease, and other unspecified anemias that do not fit into more specific categories.

How do I determine if I should use D64 or a more specific anemia code?

Review the clinical documentation carefully. If the type of anemia is specified or can be determined from lab results, use the more specific code. D64 should be used when the type is not clearly defined.