ICD-10 Code for Normocytic Anemia
The ICD-10 code for normocytic anemia is D64.9 (Anemia, unspecified).
Classification and Coding Considerations
Normocytic anemia is characterized by red blood cells of normal size (normal mean corpuscular volume, MCV 80-100 fL) and normal hemoglobin content. When documenting this condition, it's important to consider the following:
Primary code: D64.9 is the appropriate code when the specific cause of normocytic anemia is unknown or unspecified.
More specific codes should be used when the underlying cause is identified:
- D64.8: Other specified anemias
- D63.0: Anemia in chronic kidney disease
- D63.8: Anemia in other chronic diseases classified elsewhere
- D62: Acute post-hemorrhagic anemia
Clinical Context for Accurate Coding
Normocytic anemia is commonly seen in:
- Anemia of chronic disease/inflammation
- Chronic kidney disease
- Acute blood loss
- Hemolytic conditions
- Aplastic anemia
The American Society of Hematology recommends that initial testing for suspected anemia should include a CBC with differential to evaluate hemoglobin, hematocrit, MCV, RDW, and cell morphology to identify the presence and type of anemia 1.
Diagnostic Parameters
For accurate coding, document:
- Hemoglobin level (defining anemia as <13 g/dL for men and <12 g/dL for non-pregnant women)
- MCV (80-100 fL for normocytic anemia)
- Reticulocyte count (helps differentiate between production defects and blood loss/hemolysis)
- Any underlying conditions
According to the National Kidney Foundation, the anemia of CKD is most often normochromic and normocytic, and hence indistinguishable from anemia associated with other chronic conditions 2.
Common Pitfalls in Coding
Failure to code the underlying cause: When the etiology is known, code the specific type of anemia first.
Overlooking mixed anemias: Sometimes microcytosis and macrocytosis co-exist, resulting in a normal MCV. A high RDW can help identify this situation 2.
Not updating codes when diagnosis evolves: Initial normocytic anemia may later be diagnosed as a specific type requiring a more precise code.
For the most accurate coding, ensure comprehensive laboratory evaluation including CBC, reticulocyte count, and iron studies to determine the specific cause of the normocytic anemia whenever possible.