D63.8: Anemia in other chronic diseases classified elsewhere

The ICD-10-CM code for anemia that the record attributes to a named chronic disease other than a neoplasm or chronic kidney disease, reported after the code for that disease.

Billable

FY2027

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At a glance

Code Family

D63: Anemia in chronic diseases classified elsewhere.

Condition

Anemia of chronic disease.

HCC Mapping (v28)

None. D63.8 carries no CMS-HCC v28 category. The underlying disease is what carries risk weight.

DRG Grouping

MDC 16 holds the red blood cell disorder pair, MS-DRG 811 with MCC and MS-DRG 812 without MCC. D63.8 cannot hold the principal position. The base MS-DRG follows the underlying disease.

Billable

Yes, valid for HIPAA covered transactions. Never valid as the only diagnosis on the claim.

Family Specificity

Three billable child codes split on which chronic disease caused the anemia. Neoplastic disease and chronic kidney disease are carved out. D63.8 holds every other chronic disease.

Which D63 code do I assign?

Category D63 splits on which chronic disease the record names as the cause of the anemia, not on how long the anemia has been present. Neoplastic disease takes D63.0 and chronic kidney disease takes D63.1, leaving D63.8 for every other named chronic disease.

When documentation says…

Code

Chronic anemia, no underlying disease documented

D64.9

Anemia, unspecified. The record calls the anemia chronic, or attributes it to chronic disease, without naming the disease. Code D63.8 cannot be assigned, because its Code first instruction has nothing to point at. Query the provider for the underlying condition.

Simple chronic anemia

D53.9

Nutritional anemia, unspecified. The Alphabetic Index entry reading anemia, chronic simple points to D53.9. That older term is not a synonym for anemia of chronic disease. It does not reach category D63.

Anemia secondary to hypothyroidism or anemia of rheumatoid arthritis

D63.8

Anemia in other chronic diseases classified elsewhere. The chronic disease is named. It is neither a neoplasm nor chronic kidney disease. Sequence the disease code first, such as E03.9 or M06.9. Place D63.8 second.

Anemia of chronic kidney disease or erythropoietin resistant anemia

D63.1

Anemia in chronic kidney disease. Erythropoietin resistant anemia is an inclusion term at D63.1. The tabular directs the coder to code first the underlying chronic kidney disease from the N18.- codes.

Anemia due to metastatic colon cancer

D63.0

Anemia in neoplastic disease. The tabular directs the coder to code first the neoplasm, at C00–D49. Section I.C.2.c.1 of the FY2027 Official Guidelines sequences the malignancy first where the encounter treats only the anemia.

Anemia due to antineoplastic chemotherapy

D64.81

Anemia due to antineoplastic chemotherapy. Code D63.0 carries an Excludes2 note for D64.81, which permits both codes where both are documented. Where the chemotherapy is the documented cause of the anemia, D64.81 is the code for it. Code D63.8 does not apply.

Iron deficiency anemia

D50.9

Iron deficiency anemia, unspecified. A documented nutritional deficiency displaces the chronic disease code. Code D63.8 does not apply where iron, vitamin B12 or folate deficiency is named as the cause.

Tabular notes

CODE FIRST

The FY2027 tabular carries a single instruction under D63.8: code first the underlying disease, such as diphyllobothriasis (B70.0), hookworm disease (B76.0–B76.9), hypothyroidism (E00.0–E03.9), malaria (B50.0–B54), symptomatic late syphilis (A52.79) and tuberculosis (A18.89). The words such as make the list illustrative rather than closed. Any chronic disease the provider names as the cause may be sequenced first. The underlying disease code is required. D63.8 reported alone leaves the instruction unsatisfied.

EXCLUDES1

No Excludes1 note sits at D63.8, at category D63 or at block D60-D64. Nothing is barred from being reported alongside D63.8 by an Excludes1 note. The one Excludes1 in this family sits at D63.0, for aplastic anemia due to antineoplastic chemotherapy (D61.1).

EXCLUDES2

Chapter 3 carries a chapter level Excludes2 list that reaches D63.8. It names neoplasms (C00–D49), human immunodeficiency virus [HIV] disease (B20), and endocrine, nutritional and metabolic diseases (E00-E88), among others. Excludes2 means the patient may have both conditions. That is what allows the underlying disease and D63.8 to be reported on the same claim.

FY2027: EFFECTIVE 1 OCTOBER 2026

The FY2027 codes and tabular addenda make no addition, deletion or revision in category D63. D63.8's descriptor and its Code first list are unchanged in the FY2027 update. Category D63 still holds three child codes.

Operational & financial impact

Why specificity matters beyond the chart: risk adjustment, DRG assignment and denial exposure all follow from which code is selected.

CMS-HCC v28 (PY2024+)

Code D63.8 does not appear in the CMS-HCC v28 ICD-10-CM mapping for payment year 2026. It carries no HCC.

Codes D63.0 and D63.1 carry no v28 category either. The anemia code is not where the risk weight sits.

The v28 hematology categories are HCC 107, HCC 108, HCC 109, HCC 111 and HCC 112. They cover sickle cell disorders, thalassemia, acquired hemolytic, aplastic and sideroblastic anemias, hemophilia in males, immune thrombocytopenia and specified coagulation defects. Anemia in chronic disease sits in none of them.

Anemia in chronic kidney disease is coded D63.1, not D63.8.

CMS calculates 100 percent of CY2026 risk scores using the 2024 CMS-HCC model, per the CY2026 Rate Announcement.

MS-DRG v44 (FY2027)

MS-DRG 811: Red Blood Cell Disorders with MCC.

MS-DRG 812: Red Blood Cell Disorders without MCC.

Both sit in MDC 16, diseases and disorders of blood, blood forming organs and immunologic disorders.

The title of D63.8 carries the phrase classified elsewhere. Section I.A.13 of the FY2027 Official Guidelines bars such a code from the first listed or principal position. The base MS-DRG follows the underlying disease coded first, which may sit in any MDC.

Version 44.0 of the grouper applies to discharges on or after 1 October 2026.

Medicare and commercial payers

The CMS Billing and Coding article for erythropoiesis stimulating agents, A58982, names D63.8 in one group only. That group pairs D63.8 with Z01.818 and an osteoarthritis code, for presurgical anemia. The current revision of the article is effective 1 October 2026.

The same article pairs D63.1 with N18.6 for end stage renal disease on dialysis. It pairs D63.1 with I12.0, I13.11, I13.2, N18.32, N18.4 or N18.5 for chronic kidney disease not on dialysis. Code D63.8 appears in neither of those groups.

National Coverage Determination 110.21 lists the anemia of cancer not related to cancer treatment among its nationally non-covered indications for erythropoiesis stimulating agents. That determination took effect 30 July 2007.

No National Coverage Determination governs the assignment of D63.8 itself.

WHERE SPECIFICITY IS LOST

The National Institute of Diabetes and Digestive and Kidney Diseases names this entity anemia of inflammation, also called anemia of chronic disease. It lists autoimmune disease, cancer, chronic infection, chronic kidney disease and inflammatory bowel disease among the causes. The classification splits that one clinical entity across D63.0, D63.1 and D63.8. The code title never uses the clinical name.

A claim carrying D63.8 with no underlying disease coded reports a manifestation with no etiology. The Code first instruction has not been satisfied. That is the denial pattern specific to this code.

Where the underlying disease is chronic kidney disease and D63.8 was assigned, the record loses D63.1. It also loses the code pairing that the erythropoiesis stimulating agent coverage article is written against.

Where the underlying disease is a neoplasm and D63.8 was assigned, the record loses D63.0.

Where a chronic disease is documented as the cause and D64.9 was assigned, the etiology link is dropped from the claim. The anemia reads as a condition of unknown type.

Where iron, vitamin B12 or folate deficiency is the documented cause, the nutritional anemia codes apply. Anemia of inflammation and iron deficiency anemia are separate entities with separate codes.

SEVERITY DESIGNATION (MS-DRG V44.0)

D63.8 carries no severity designation. It appears in neither Appendix G, the CC list, nor Appendix H, the MCC list, of the ICD-10 MS-DRG Definitions Manual Version 44.0. A case reaches the higher tier of its DRG pair on a designation carried by another diagnosis.

Documentation checklist to support D63.8

Chart elements that support code selection and reduce specificity-driven denials.

A provider statement of anemia, with the laboratory values that support it. A hemoglobin result on its own does not carry the diagnosis.

The chronic disease named in the same record, with its own code available to sequence first.

An explicit causal statement linking the anemia to that chronic disease. Two entries sitting on the same problem list is not a stated link.

The underlying disease code placed ahead of D63.8 in the sequence, in both the inpatient and the professional claim.

Confirmation that the named chronic disease is neither a neoplasm nor chronic kidney disease. Those two take D63.0 and D63.1.

Evidence that a treatable deficiency was considered. Where iron, vitamin B12 or folate deficiency is documented as the cause, the nutritional anemia code applies instead.

Where the anemia is attributed to antineoplastic chemotherapy, the documented link to that therapy, which directs the encounter to D64.81.

For a presurgical erythropoiesis stimulating agent encounter, the preprocedural examination code and the surgical indication that the CMS billing and coding article for those agents requires.

For outpatient encounters, a confirmed diagnosis only. A probable or suspected anemia is not coded as confirmed in the outpatient setting.

FAQ

Is D63.8 the code for chronic anemia?

No. Code D63.8 is anemia caused by another chronic disease. It is not anemia that has lasted a long time. The Alphabetic Index entry anemia, chronic carries no code of its own. An unqualified anemia takes D64.9. The Index sends the older term anemia, chronic simple to D53.9.

Can D63.8 be the principal or first-listed diagnosis?

No. Its title carries the phrase classified elsewhere. Section I.A.13 of the FY2027 Official Guidelines states that such codes are never permitted as first listed or principal diagnosis codes. They must be used with an underlying condition code and must be listed after it.

How is D63.8 different from D63.1?

Chronic kidney disease is carved out of D63.8 and given its own code at D63.1. Code D63.1 carries a Code first instruction for the underlying chronic kidney disease from the N18.- codes. It also carries erythropoietin resistant anemia as an inclusion term.

Does D63.8 map to an HCC under CMS-HCC v28?

No. Code D63.8 does not appear in the CMS-HCC v28 ICD-10-CM mapping for payment year 2026. Codes D63.0 and D63.1 carry no HCC either. Risk weight on these encounters comes from the underlying disease, such as a stage specific chronic kidney disease code.

The note says anemia of chronic disease but names no disease. What do I assign?

Assign D64.9, anemia unspecified. Query the provider for the chronic disease. The Index sends anemia due to chronic disease classified elsewhere NEC to D63.8. That entry does not satisfy the Code first instruction, which requires a coded underlying disease.

Which chronic diseases support D63.8?

The tabular list is illustrative. It is introduced by the words such as. It names diphyllobothriasis, hookworm disease, hypothyroidism, malaria, symptomatic late syphilis and tuberculosis. Other chronic diseases qualify where the provider documents the anemia as caused by them.

Is D63.8 billable, and did anything change for FY2027?

Code D63.8 is billable in the FY2027 code set, effective 1 October 2026. D63.8 is unchanged in the FY2027 update, which makes no addition, deletion or revision in category D63.

Does the sequencing rule differ between inpatient and outpatient coding?

No. The etiology and manifestation sequence applies in both settings. On an inpatient claim the underlying disease is the principal diagnosis and D63.8 is a secondary diagnosis. On a professional claim the underlying disease is the first listed diagnosis.

Related codes

Codes in the same family as D63.8. Only codes with a published page render as links.

Sibling codes in the D63 family

D63.0: Anemia in neoplastic disease.
D63.1: Anemia in chronic kidney disease.

Additional codes to consider

Codes outside the D63 family considered alongside D63.8.

Companion: code alongside when documented

E03.9: Hypothyroidism, unspecified. Named in the Code first list at D63.8.
A18.89: Tuberculosis of other sites. Named in the Code first list at D63.8.
B70.0: Diphyllobothriasis. Named in the Code first list at D63.8.
B76.9: Hookworm disease, unspecified. Named in the Code first list at D63.8.
B54: Unspecified malaria. Named in the Code first list at D63.8.
A52.79: Other symptomatic late syphilis. Named in the Code first list at D63.8.
M06.9: Rheumatoid arthritis, unspecified. A chronic disease outside the illustrative list, sequenced first where the provider states the anemia is caused by it.
M32.9: Systemic lupus erythematosus, unspecified.
K50.90: Crohn's disease, unspecified, without complications.
K51.90: Ulcerative colitis, unspecified, without complications.
B20: Human immunodeficiency virus [HIV] disease.
I50.22: Chronic systolic (congestive) heart failure.
N18.9: Chronic kidney disease, unspecified. Where chronic kidney disease is the underlying disease, the anemia takes D63.1 rather than D63.8. Code the stage specific N18 code where the provider documents a stage.

Consider instead

D63.1: Anemia in chronic kidney disease. Assign this code when the underlying chronic disease is chronic kidney disease. Code first from the N18.- codes.
D63.0: Anemia in neoplastic disease. Assign this code when the underlying chronic disease is a neoplasm. Code the neoplasm first.
D64.9: Anemia, unspecified. This is where an unqualified or long standing anemia goes when no underlying disease is documented.
D50.9: Iron deficiency anemia, unspecified. Assign this code when iron deficiency is documented as the cause.
D53.9: Nutritional anemia, unspecified. The Alphabetic Index sends the term anemia, chronic simple to this code.
D51.9: Vitamin B12 deficiency anemia, unspecified.
D52.9: Folate deficiency anemia, unspecified.
D64.81: Anemia due to antineoplastic chemotherapy.
D62: Acute posthemorrhagic anemia, for an acute blood loss anemia rather than a chronic disease anemia.
D61.9: Aplastic anemia, unspecified.
D59.9: Acquired hemolytic anemia, unspecified.

Sources

All claims on this page derive from government and professional-standards sources.

National Center for Health Statistics. (2026). International classification of diseases, tenth revision, clinical modification (ICD-10-CM) FY2027 files. https://www.cdc.gov/nchs/icd/icd-10-cm/files.html
Centers for Medicare & Medicaid Services and National Center for Health Statistics. (2026). ICD-10-CM official guidelines for coding and reporting FY2027. https://ftp.cdc.gov/pub/Health_Statistics/NCHS/Publications/ICD10CM/2027/ICD-10-CM-October-1-2026-FY27-Guidelines.pdf
Centers for Medicare & Medicaid Services. (2025). 2026 model software/ICD-10 mappings. https://www.cms.gov/medicare/payment/medicare-advantage-rates-statistics/risk-adjustment/2026-model-software-icd-10-mappings
Centers for Medicare & Medicaid Services. (2026). MS-DRG classifications and software, version 44. https://www.cms.gov/medicare/payment/prospective-payment-systems/acute-inpatient-pps/ms-drg-classifications-and-software