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ICD-10 Coding for Anemia of Chronic Renal Failure(D63.1, N18.x)

Complete ICD-10-CM coding and documentation guide for Anemia of Chronic Renal Failure. Includes clinical validation requirements, documentation requirements, and coding pitfalls.

Also known as:

Anemia in Chronic Kidney DiseaseRenal Anemia

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Related ICD-10 Code Ranges

Complete code families applicable to Anemia of Chronic Renal Failure

D63-D64Primary Range

Anemia in chronic diseases classified elsewhere

This range includes anemia associated with chronic conditions like CKD, specifically coded as D63.1.

N18-N19

Chronic kidney disease (CKD)

This range includes codes for CKD stages, which are necessary to pair with D63.1 for complete coding.

Code Comparison: When to Use Each Code

Compare key differences between these codes to ensure accurate selection

CodeDescriptionWhen to UseKey Documentation
D63.1Anemia in chronic kidney diseaseUse when anemia is present in a patient with CKD stage 3 or higher.
  • Hemoglobin <13 g/dL (men) or <12 g/dL (women)
  • eGFR <60 mL/min/1.73m²
N18.xChronic kidney disease, stage-specificUse to specify the stage of CKD in conjunction with D63.1.
  • eGFR <60 mL/min/1.73m² for ≥3 months

Clinical Decision Support

Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.

Key Information: ICD-10 code for anemia of chronic renal failure

Essential facts and insights about Anemia of Chronic Renal Failure

The ICD-10 code for anemia in chronic renal failure is D63.1, used when anemia is associated with chronic kidney disease (CKD).

Primary ICD-10-CM Codes for anemia of chronic renal failure

D63.1
Anemia in chronic kidney disease
Billable Code

Decision Criteria

clinical Criteria

  • Presence of anemia and CKD stage 3 or higher.

documentation Criteria

  • Documentation of both anemia and CKD in the medical record.

Applicable To

  • Anemia due to CKD

Excludes

  • Anemia in neoplastic disease (D63.0)
  • Iron deficiency anemia (D50.9)

Clinical Validation Requirements

  • Hemoglobin <13 g/dL (men) or <12 g/dL (women)
  • eGFR <60 mL/min/1.73m²

Code-Specific Risks

  • Incorrectly using D64.9 when CKD is documented.

Coding Notes

  • Ensure CKD stage is documented to support D63.1 coding.
View Full Code Details

Ancillary Codes

Additional codes that should be used in conjunction with the main diagnosis codes when applicable.

Dependence on renal dialysis

Z99.2
Use if the patient is on dialysis.

Diabetes with CKD

E11.22
Use if diabetes is the underlying cause of CKD.

Differential Codes

Alternative codes to consider when ruling out similar conditions to the primary diagnosis.

Unspecified anemia

D64.9
Use only if CKD is not documented.

Anemia in neoplastic disease

D63.0
Use if anemia is directly caused by malignancy.

Documentation & Coding Risks

Avoid these common documentation and coding issues when documenting Anemia of Chronic Renal Failure to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code D63.1.

Impact

Clinical: Inaccurate clinical representation of patient's condition., Regulatory: Non-compliance with coding guidelines., Financial: Potential underpayment due to incorrect DRG assignment.

Mitigation Strategy

Ensure CKD stage is documented in the medical record., Verify lab results are included to support anemia diagnosis.

Impact

Reimbursement: Potential loss of MCC status, affecting DRG assignment., Compliance: Non-compliance with ICD-10 guidelines., Data Quality: Inaccurate representation of patient condition.

Mitigation Strategy

Always use D63.1 if CKD is present.

Impact

Missing CKD stage documentation when coding D63.1.

Mitigation Strategy

Implement checklist to ensure CKD stage is documented.

Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.

Frequently Asked Questions

Common questions about ICD-10 coding for Anemia of Chronic Renal Failure, with expert answers to help guide accurate code selection and documentation.

Documentation Templates for Anemia of Chronic Renal Failure

Use these documentation templates to ensure complete and accurate documentation for Anemia of Chronic Renal Failure. These templates include all required elements for proper coding and billing.

Nephrology Progress Note

Specialty: Nephrology

Required Elements

  • CKD stage
  • Hemoglobin levels
  • eGFR
  • Symptoms
  • Treatment plan

Example Documentation

Diagnoses: 1. CKD stage 3b (N18.32) 2. Anemia in CKD (D63.1) Assessment: Hb 10.2 g/dL, eGFR 38 mL/min/1.73m². Plan: Initiate ESA therapy.

Examples: Poor vs. Good Documentation

Poor Documentation Example
Patient has anemia and CKD.
Good Documentation Example
Hb 9.5 g/dL, eGFR 42 mL/min/1.73m². Anemia secondary to CKD stage 3b, no iron deficiency.
Explanation
The good example provides specific lab values and links anemia to CKD.

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