Is D63.1 a billable ICD-10-CM code?

Yes. D63.1 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does D63.1 sit in the tabular list?

Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism (D50-D89), in the block Aplastic and other anemias and other bone marrow failure syndromes (D60-D64).

D63.1

D63.1 — Anemia in chronic kidney disease

Billable / specific codeICD-10-CM

D63.1 is a billable, specific ICD-10-CM code for anemia in chronic kidney disease. It is valid for submission on a claim.

Code first

The underlying condition must be sequenced before this code.

underlying chronic kidney disease (CKD) (N18.-)

Inclusion terms

Alternative wordings a physician may use in the chart for this same code.

Erythropoietin resistant anemia (EPO resistant anemia)

Risk adjustment

D63.1 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.

Medicare coverage

D63.1 is named in 15 Medicare coverage policies — 15 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A56416Billing and Coding: Assays for Vitamins and Metabolic Function
A56462Billing and Coding: Erythropoiesis Stimulating Agents (ESA)
A56795Billing and Coding: Erythropoiesis Stimulating Agents (ESAs)
A56795Billing and Coding: Erythropoiesis Stimulating Agents (ESAs)

How D63.1 is indexed

Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to D63.1.

Anemia›erythropoietin-resistant anemia(EPO resistant anemia)
Anemia›due to›chronic kidney disease
Anemia›due to›end stage renal disease
Anemia›in›chronic kidney disease
Anemia›in›end stage renal disease
Anemia›in›failure, kidney(renal)

Related codes at this level

Codes that share D63. If D63.1 is not quite right, the correct code is usually one of these.

Questions about D63.1

Is D63.1 a billable ICD-10-CM code?: Yes. D63.1 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does D63.1 sit in the tabular list?: Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism (D50-D89), in the block Aplastic and other anemias and other bone marrow failure syndromes (D60-D64).