Anemia ICD 10 Codes: Complete 2026 Coding Guide for D64.9, D50, D63 and More

Anemia does not have one ICD 10 CM code.

The correct code depends on what caused the anemia, what type the provider documented, and whether another condition caused or contributed to it. That distinction matters because D64.9, anemia unspecified, should not replace a more specific diagnosis wen the medical record supports one.

For example, iron deficiency anemia generally falls under D50, anemia in chronic kidney disease uses D63.1 with an additional CKD code, anemia caused by malignancy uses D63.0, and chemotherapy induced anemia uses D64.81.

This guide explains the most commonly used anemia ICD 10 codes, how to select the right code, when to use D64.9, sequencing rules, documentation requirements, common coding mistakes, and practical examples for coders and providers.

What Is the ICD 10 Code for Anemia?

The ICD 10 CM code for anemia, unspecified is D64.9.

D64.9 is billable and valid for FY 2026 when the provider documents anemia but does not identify a specific type or cause.

However, D64.9 does not mean “use this code whenever the patient has anemia.”

If the provider documents iron deficiency, chronic kidney disease related anemia, acute blood loss, vitamin B12 deficiency, folate deficiency, malignancy related anemia, or chemotherapy induced anemia, a more specific code may apply.

Common anemia ICD 10 codes

Diagnosis	ICD 10 CM code	Coding consideration
Anemia, unspecified	D64.9	Use when the provider does not identify the type or cause
Iron deficiency anemia due to chronic blood loss	D50.0	Chronic blood loss must be documented
Sideropenic dysphagia	D50.1	Specific iron deficiency condition
Other iron deficiency anemias	D50.8	Use when the documented condition fits this category
Iron deficiency anemia, unspecified	D50.9	Iron deficiency is documented but the cause is not further specified
Vitamin B12 deficiency anemia	D51.9	B12 deficiency anemia without further specificity
Pernicious anemia	D51.0	B12 deficiency anemia due to intrinsic factor deficiency
Folate deficiency anemia, unspecified	D52.9	Folate deficiency anemia without additional specificity
Nutritional anemia, unspecified	D53.9	Nutritional anemia without a more specific diagnosis
Acute posthemorrhagic anemia	D62	Acute blood loss anemia
Anemia in neoplastic disease	D63.0	Underlying malignancy must be coded first
Anemia in chronic kidney disease	D63.1	Code the CKD first and add the appropriate N18 code
Anemia in other chronic diseases	D63.8	Underlying disease must also be coded
Anemia due to antineoplastic chemotherapy	D64.81	Apply the applicable sequencing and adverse effect codes
Other specified anemias	D64.89	Use when the anemia has a specified cause not represented by a more specific code

CMS lists these diagnoses within the FY 2026 ICD 10 CM code set.

Understanding the Anemia ICD 10 CM Categories

Most commonly searched anemia codes fall within the D50 through D64 range, but anemia related to conditions such as sickle cell disease and thalassemia appears in other D categories.

Understanding the category helps prevent a common mistake: choosing a code based only on the word “anemia” instead of identifying the underlying diagnosis.

D50: Iron deficiency anemia

The D50 category covers iron deficiency anemia.

Important codes include:

• D50.0: Iron deficiency anemia secondary to blood loss, chronic
• D50.1: Sideropenic dysphagia
• D50.8: Other iron deficiency anemias
• D50.9: Iron deficiency anemia, unspecified

D50 itself represents a category and does not function as the final billable diagnosis. The coder should select the appropriate child code supported by the documentation.

D51: Vitamin B12 deficiency anemia

The D51 category covers vitamin B12 deficiency anemia.

Examples include:

• D51.0: Vitamin B12 deficiency anemia due to intrinsic factor deficiency, commonly associated with pernicious anemia
• D51.1: Selective vitamin B12 malabsorption
• D51.8: Other vitamin B12 deficiency anemias
• D51.9: Vitamin B12 deficiency anemia, unspecified

Do not automatically assign a B12 deficiency anemia code because laboratory testing shows a low B12 level. The provider must document the diagnosis that supports code assignment.

D52: Folate deficiency anemia

The D52 category includes folate deficiency anemia.

Common codes include:

• D52.0: Dietary folate deficiency anemia
• D52.1: Drug induced folate deficiency anemia
• D52.8: Other folate deficiency anemias
• D52.9: Folate deficiency anemia, unspecified

The documentation should establish the diagnosis and, when relevant, the cause.

D53: Other nutritional anemias

D53 covers nutritional anemias that do not fit the more specific categories above.

Examples include:

• D53.0: Protein deficiency anemia
• D53.1: Other megaloblastic anemias, not elsewhere classified
• D53.2: Scorbutic anemia
• D53.8: Other specified nutritional anemias
• D53.9: Nutritional anemia, unspecified

CMS includes these codes in the FY 2026 code set.

D55 through D59: Hemolytic anemias and related disorders

The D55 through D59 categories cover several inherited and acquired hemolytic anemias.

Examples include anemia associated with:

1. G6PD deficiency
2. Other enzyme disorders
3. Thalassemia
4. Sickle cell disease
5. Hereditary hemolytic disorders
6. Acquired hemolytic anemia

These diagnoses require more specific coding than simply assigning D64.9.

D60 and D61: Aplastic and bone marrow failure anemias

These categories include aplastic anemia and other bone marrow failure syndromes.

For example, D61.9 represents aplastic anemia, unspecified.

Do not confuse aplastic anemia with unspecified anemia. A provider documented diagnosis of aplastic anemia supports a fundamentally different code family.

D62: Acute posthemorrhagic anemia

D62 represents acute posthemorrhagic anemia.

This code differs from D50.0.

The distinction matters:

• D50.0 applies to iron deficiency anemia caused by chronic blood loss.
• D62 applies to acute posthemorrhagic anemia.

For example, a patient develops documented acute blood loss anemia after major surgery. D62 may apply. A patient develops iron deficiency anemia from documented chronic gastrointestinal blood loss. D50.0 may apply.

The provider should make the acute or chronic nature of the blood loss clear.

D63: Anemia in chronic diseases classified elsewhere

D63 includes anemia associated with an underlying disease.

The most important codes include:

• D63.0: Anemia in neoplastic disease
• D63.1: Anemia in chronic kidney disease
• D63.8: Anemia in other chronic diseases classified elsewhere

These codes require attention to sequencing and the underlying condition.

D64: Other anemias

The D64 category includes several other forms of anemia.

Important codes include:

• D64.0: Hereditary sideroblastic anemia
• D64.1: Secondary sideroblastic anemia due to disease
• D64.2: Secondary sideroblastic anemia due to drugs and toxins
• D64.3: Other sideroblastic anemias
• D64.4: Congenital dyserythropoietic anemia
• D64.81: Anemia due to antineoplastic chemotherapy
• D64.89: Other specified anemias
• D64.9: Anemia, unspecified

CMS lists these codes in the FY 2026 ICD 10 CM material.

D64.9: When Should You Use Anemia Unspecified?

D64.9 is one of the most commonly searched anemia diagnosis codes.

The correct description is Anemia, unspecified.

Use D64.9 when the provider documents anemia but does not establish a more specific type, cause, or relationship to another condition.

For example:

Assessment: Anemia, unspecified.

If the record contains no documented diagnosis explaining the anemia, D64.9 may be appropriate.

But coders should not treat D64.9 as the automatic answer for every anemia encounter.

When D64.9 may be appropriate

D64.9 may apply when the documentation says:

• “Anemia”
• “Anemia NOS”
• “Unspecified anemia”
• “Chronic anemia” without an identified cause
• “Severe anemia” without a documented type or etiology

The key issue is that the provider has diagnosed anemia but has not established its cause or specific type.

When D64.9 may not be appropriate

Do not default to D64.9 when the provider clearly documents:

• Iron deficiency anemia
• Pernicious anemia
• Anemia due to chronic kidney disease
• Anemia due to malignancy
• Chemotherapy induced anemia
• Acute posthemorrhagic anemia
• Folate deficiency anemia
• Vitamin B12 deficiency anemia
• Aplastic anemia
• Hemolytic anemia
• Thalassemia
• Sickle cell disease

The more specific diagnosis should guide code selection.

Does Low Hemoglobin Automatically Mean Anemia?

No.

A low hemoglobin result does not automatically give the coder permission to assign an anemia diagnosis.

This distinction matters because ICD 10 CM coding relies on provider documentation and the applicable coding guidelines. Laboratory findings can support clinical decision making, but the coder should not independently create a diagnosis from a lab value when the provider has not documented the condition.

For example:

• Lab: Hemoglobin 8.9 g/dL
• Assessment: No anemia diagnosis documented.

Do not automatically assign D64.9 based only on the laboratory result.

Now consider:

• Lab: Hemoglobin 8.9 g/dL
• Assessment: Iron deficiency anemia due to chronic blood loss.

The provider documentation supports a much more specific diagnosis, so D50.0 may apply when the documentation supports chronic blood loss as the cause.

Iron Deficiency Anemia ICD 10 Codes

Iron deficiency represents one of the most common anemia coding scenarios.

The correct code depends on what the provider documents.

D50.9: Iron deficiency anemia, unspecified

Use D50.9 when the provider documents iron deficiency anemia but does not identify a more specific cause or category.

Example:

• Assessment: Iron deficiency anemia.
• Code: D50.9

Do not change D50.9 to D50.0 simply because the patient has a history of gastrointestinal problems. The provider must establish the documented relationship to chronic blood loss.

D50.0: Iron deficiency anemia due to chronic blood loss

Use D50.0 when the provider documents iron deficiency anemia secondary to chronic blood loss.

Possible clinical situations can include chronic gastrointestinal blood loss or another documented source of ongoing blood loss.

The coding decision should follow the provider’s diagnosis rather than the coder’s interpretation of laboratory results.

D50.8: Other iron deficiency anemias

D50.8 applies when the provider documents a specified iron deficiency anemia that does not fit D50.0 or D50.1.

D50.1: Sideropenic dysphagia

D50.1 represents sideropenic dysphagia.

This is a specific diagnosis and should not serve as a general code for iron deficiency anemia.

Anemia in Chronic Kidney Disease: D63.1

Anemia associated with chronic kidney disease requires special attention.

D63.1 represents anemia in chronic kidney disease.

The ICD 10 CM Tabular instructions require the underlying CKD to receive coding as well. CMS materials state that the underlying CKD code from N18 should come first.

A typical sequence looks like:

N18.x → D63.1

The exact N18 code depends on the documented CKD stage.

For example, if the provider documents:

“CKD stage 4 with anemia of CKD”

The coder should identify the appropriate stage specific N18 code and add D63.1.

Do not report D63.1 alone when the coding instructions require the underlying CKD code.

Why documentation matters for D63.1

A patient may have both CKD and anemia.

That does not automatically establish that CKD caused the anemia for every coding situation.

The provider should document the relationship, such as:

“Anemia due to CKD”

“Anemia of chronic kidney disease”

“CKD associated anemia”

Clear linkage gives the coder a defensible basis for D63.1.

Anemia in Neoplastic Disease: D63.0

D63.0 represents anemia in neoplastic disease.

The underlying malignancy must also receive coding.

CMS’s FY 2026 Official Guidelines state that when the encounter involves management of anemia associated with malignancy and treatment focuses only on the anemia, the malignancy code comes first, followed by the anemia code.

The basic sequence is:

Malignancy code → D63.0

Do not confuse D63.0 with chemotherapy induced anemia.

If the cancer itself causes the anemia, D63.0 may apply.

If chemotherapy causes the anemia, D64.81 may apply instead.

That distinction can significantly change the coding sequence.

Chemotherapy Induced Anemia: D64.81

D64.81 represents anemia due to antineoplastic chemotherapy.

This code deserves special attention because coders sometimes confuse it with D63.0.

Consider two scenarios.

Scenario 1: Cancer causes anemia

Provider documents:

“Anemia due to active malignancy.”

The applicable anemia code may be D63.0, with the malignancy coded first according to the applicable guidelines.

Scenario 2: Chemotherapy causes anemia

Provider documents:

“Anemia due to chemotherapy.”

D64.81 applies.

For encounters specifically involving management of anemia caused by chemotherapy or immunotherapy, the FY 2026 Official Guidelines provide a different sequencing approach. The anemia code comes first, followed by the neoplasm and applicable adverse effect code.

This distinction is easy to miss:

• Cancer caused the anemia: D63.0
• Chemotherapy caused the anemia: D64.81

Always follow the documented cause and the applicable sequencing instructions.

Anemia Due to Radiation Therapy

Radiation therapy can also cause anemia.

The FY 2026 Official Guidelines address anemia associated with adverse effects of radiotherapy. When the encounter focuses on management of the anemia, the anemia code comes first, followed by the appropriate neoplasm code and the applicable external cause code for radiotherapy.

Because therapy related coding involves multiple codes and sequencing rules, coders should review the current Official Guidelines rather than relying on a generic anemia code list.

Vitamin B12 Deficiency Anemia ICD 10

B12 deficiency anemia falls within D51.

Some commonly encountered codes include:

• D51.0: Vitamin B12 deficiency anemia due to intrinsic factor deficiency
• D51.1: Vitamin B12 deficiency anemia due to selective vitamin B12 malabsorption
• D51.8: Other vitamin B12 deficiency anemias
• D51.9: Vitamin B12 deficiency anemia, unspecified

If the provider documents pernicious anemia, D51.0 may apply.

If the provider documents B12 deficiency anemia without additional specificity, D51.9 may apply.

Again, the laboratory result alone should not determine the diagnosis code.

Folate Deficiency Anemia ICD 10

Folate deficiency anemia falls within D52.

Common codes include:

• D52.0: Dietary folate deficiency anemia
• D52.1: Drug induced folate deficiency anemia
• D52.8: Other folate deficiency anemias
• D52.9: Folate deficiency anemia, unspecified

The provider’s documentation should establish the diagnosis and, when applicable, the underlying cause.

Acute Blood Loss Anemia vs Chronic Blood Loss Anemia

This distinction causes frequent coding confusion.

Acute blood loss

Use D62 when the provider documents acute posthemorrhagic anemia.

Chronic blood loss with iron deficiency anemia

Use D50.0 when the provider documents iron deficiency anemia secondary to chronic blood loss.

These are not interchangeable.

A patient who loses a significant amount of blood during surgery may develop acute posthemorrhagic anemia.

A patient with ongoing chronic gastrointestinal bleeding may develop iron deficiency anemia from chronic blood loss.

The provider should document the clinical relationship clearly.

What ICD 10 Code Should You Use for Severe Anemia?

There is no separate ICD 10 CM code simply for “severe anemia.”

Severity does not automatically determine the code.

If the provider documents:

“Severe anemia”

but does not identify a type or cause, D64.9 may be appropriate.

If the provider documents:

“Severe iron deficiency anemia due to chronic blood loss”

then a more specific code such as D50.0 may apply.

The word “severe” does not replace the underlying diagnosis.

What ICD 10 Code Should You Use for Chronic Anemia?

“Chronic anemia” does not automatically equal D63.8.

This point deserves attention.

D63.8 represents anemia in other chronic diseases classified elsewhere. The provider needs to establish the relationship between the anemia and the underlying disease.

If the documentation only says:

“Chronic anemia”

and does not identify the cause, D64.9 may be appropriate.

If the provider documents:

“Anemia due to rheumatoid arthritis”

then D63.8 may be considered along with the underlying condition, subject to the applicable coding instructions.

If the provider documents:

“Anemia due to CKD”

then D63.1 applies with the required CKD code.

Macrocytic Anemia ICD 10 Coding

Macrocytic describes the morphology of the red blood cells. It does not automatically identify the cause.

A provider may document macrocytic anemia caused by:

Vitamin B12 deficiency

Folate deficiency

Medication effects

Alcohol related disease

Bone marrow disorders

Other conditions

The coder should identify the provider’s documented diagnosis and cause rather than assigning a code based only on the MCV.

For example:

Macrocytic anemia due to B12 deficiency

A D51 code may apply.

Macrocytic anemia, cause not documented

The documentation may not support a specific nutritional anemia code. A provider query may help clarify the diagnosis.

Normocytic Anemia ICD 10 Coding

Normocytic anemia also describes morphology rather than etiology.

Possible causes include chronic kidney disease, chronic inflammation, blood loss, hemolysis, and other disorders.

Do not automatically assign D63.8 because the provider documented normocytic anemia.

First determine whether the provider documented the underlying cause.

If the chart simply says “normocytic anemia” without an identified cause, D64.9 may be the appropriate option.

Anemia of Chronic Disease ICD 10

“Anemia of chronic disease” can create coding questions because the phrase does not point to one universal code.

The correct code depends on the underlying disease.

For CKD:

N18.x → D63.1

For neoplastic disease:

Malignancy code → D63.0

For other qualifying chronic diseases:

Underlying disease → D63.8

The D63 category includes anemia associated with conditions classified elsewhere, so the underlying disease remains an important part of the coding picture.

Anemia Coding and Provider Documentation

Good documentation makes anemia coding much easier.

A useful anemia documentation checklist should answer several questions.

What type of anemia does the patient have?

Examples include:

• Iron deficiency anemia
• Acute blood loss anemia
• B12 deficiency anemia
• Folate deficiency anemia
• Hemolytic anemia
• Aplastic anemia
• Anemia of CKD
• Chemotherapy induced anemia

What caused the anemia?

The provider should document the cause when known.

For example:

• “Anemia due to CKD”
• “Iron deficiency anemia due to chronic GI blood loss”
• “Anemia due to chemotherapy”
• “Anemia secondary to active malignancy”

Is blood loss acute or chronic?

This distinction can determine whether D62 or D50.0 applies.

Is another condition responsible?

Look for documented relationships involving:

• CKD
• Cancer
• Chemotherapy
• Radiation therapy
• Nutritional deficiency
• Chronic inflammatory disease
• Medication effects
• Bone marrow disorders

Does the diagnosis appear in the provider assessment?

The coder should not create a diagnosis solely from a laboratory result.

Can a Coder Use Laboratory Results to Select an Anemia Code?

Laboratory results can provide important clinical context, but they do not automatically replace provider documentation.

Consider a CBC showing:

• Low hemoglobin
• Low hematocrit
• Low MCV
• Low ferritin

These findings may strongly suggest iron deficiency.

However, the coder should not independently turn those findings into a diagnosis of iron deficiency anemia when the provider has not documented the condition.

A provider query may resolve the documentation gap.

This approach follows the broader ICD 10 CM principle that code assignment depends on the provider’s documented diagnostic statement and the applicable Official Guidelines.

Common Anemia Coding Mistakes

Using D64.9 for every anemia diagnosis

D64.9 works for unspecified anemia.

It does not replace a documented cause specific diagnosis.

Confusing D50.0 and D62

D50.0 represents iron deficiency anemia due to chronic blood loss.

D62 represents acute posthemorrhagic anemia.

The acute versus chronic distinction matters.

Reporting D63.1 without the CKD code

D63.1 requires attention to the underlying CKD code.

Review the documented CKD stage and sequence the codes according to the Tabular instructions.

Confusing cancer related anemia with chemotherapy induced anemia

D63.0 and D64.81 do not represent the same clinical relationship.

Ask:

Did the malignancy cause the anemia?

Or did the treatment cause it?

The answer changes the code selection and sequencing.

Coding from laboratory results alone

A low hemoglobin value does not automatically equal a billable anemia diagnosis.

Review the provider’s assessment.

Treating morphology as etiology

Normocytic and macrocytic describe cell characteristics.

They do not automatically identify the underlying cause.

Ignoring the documentation relationship

Having CKD and anemia on the same claim does not necessarily establish that CKD caused the anemia.

The provider should document the relationship when required.

Anemia ICD 10 Code Selection: A Simple Decision Process

When you encounter anemia in a medical record, work through this sequence.

Step 1: Confirm that the provider documented anemia

Do not build the diagnosis from laboratory findings alone.

Step 2: Identify the documented type

Ask whether the provider documented:

• Iron deficiency
• B12 deficiency
• Folate deficiency
• Acute blood loss
• Hemolysis
• Aplastic anemia
• Thalassemia
• Sickle cell disease
• Another specified anemia

Step 3: Identify the underlying cause

Look for documented relationships with:

• CKD
• Malignancy
• Chemotherapy
• Radiation therapy
• Chronic disease
• Nutritional deficiency
• Blood loss
• Medications or toxins

Step 4: Review the Tabular instructions

Some anemia codes require additional codes or sequencing.

This step becomes especially important for D63.0, D63.1, D63.8, and D64.81.

Step 5: Use D64.9 only when the documentation supports unspecified anemia

Do not choose D64.9 simply because it appears first in a search result.

Step 6: Query when documentation remains unclear

A compliant provider query can clarify the diagnosis when the record contains clinically relevant information but does not clearly establish the diagnosis needed for accurate code assignment.

2026 ICD 10 CM Anemia Coding: What Coders Should Check

For current FY 2026 coding, always verify the code against the applicable CMS files and Official Guidelines.

CMS currently identifies FY 2026 ICD 10 CM files for encounters through September 30, 2026. CMS has also published the FY 2027 ICD 10 CM files, which apply beginning October 1, 2026.

That means a coding reference page should not simply say “2026” without explaining the effective period.

For production coding, check the code set that applies to the actual date of service or encounter.

Final Takeaway

Anemia coding starts with one simple question:

What did the provider actually diagnose, and what caused it?

D64.9 remains the correct code for unspecified anemia when the documentation does not provide additional specificity. But coders should not stop there when the medical record supports a more precise diagnosis.

Use D50 codes for iron deficiency anemia, D51 codes for vitamin B12 deficiency anemia, D52 codes for folate deficiency anemia, D62 for acute posthemorrhagic anemia, D63.0 for anemia in neoplastic disease, D63.1 for anemia in CKD, D63.8 for qualifying anemia associated with other chronic diseases, and D64.81 for chemotherapy induced anemia.

The safest approach combines three things:

1. Clear provider documentation
2. The most specific ICD 10 CM code supported by that documentation
3. Correct sequencing and additional code instructions from the current Tabular List and Official Guidelines

CMS remains the authoritative source for the current ICD 10 CM code files and coding guidance.

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Frequently Asked Questions 

What is the ICD 10 code for anemia unspecified?

D64.9 represents anemia, unspecified. Use it when the provider documents anemia without establishing a more specific type or cause.

What is the ICD 10 code for iron deficiency anemia?

D50.9 represents iron deficiency anemia, unspecified. D50.0 applies when the provider documents iron deficiency anemia due to chronic blood loss.

What is the ICD 10 code for anemia in CKD?

D63.1 represents anemia in chronic kidney disease. The appropriate CKD code from N18 should also be reported according to the Tabular instructions.

What is the ICD 10 code for anemia of chronic disease?

There is no single code for every form of anemia associated with chronic disease.

D63.1 applies to anemia in CKD.

D63.0 applies to anemia in neoplastic disease.

D63.8 applies to anemia in other chronic diseases classified elsewhere when the documentation supports the relationship.

What is the ICD 10 code for severe anemia?

ICD 10 CM does not provide a separate general code simply for severe anemia.

The code depends on the documented type and cause. If the provider documents only “severe anemia” without further specificity, D64.9 may apply.

Can low hemoglobin be coded as anemia?

Not automatically.

The provider should document the anemia diagnosis. A laboratory result by itself should not automatically lead to D64.9.

What is the difference between D63.0 and D64.81?

D63.0 represents anemia in neoplastic disease.

D64.81 represents anemia due to antineoplastic chemotherapy.

The underlying cause and the treatment relationship determine which code applies.