ICD-10 Coding for Pernicious Anemia(D51.0, D51.9)
Complete ICD-10-CM coding and documentation guide for Pernicious Anemia. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Pernicious Anemia
D50-D53Primary Range
Nutritional anemias
This range includes pernicious anemia and other nutritional anemias.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| D51.0 | Pernicious anemia | Use when intrinsic factor deficiency is confirmed with lab tests. |
|
| D51.9 | Vitamin B12 deficiency anemia, unspecified | Use when the cause of B12 deficiency is unclear or not documented. |
|
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 pernicious anemia
Essential facts and insights about Pernicious Anemia
Primary ICD-10-CM Codes for pernicious anemia
Decision Criteria
clinical Criteria
- Positive intrinsic factor antibody test
documentation Criteria
- Documented intrinsic factor deficiency
Applicable To
- Autoimmune gastritis with intrinsic factor deficiency
Clinical Validation Requirements
- Positive intrinsic factor antibody
- Elevated serum gastrin >200 pg/mL
- Methylmalonic acid >0.4 nmol/mL
Code-Specific Risks
- Incorrectly coding as D51.9 without confirming intrinsic factor deficiency.
Coding Notes
- Ensure documentation specifies intrinsic factor deficiency.
D51.9 - Vitamin B12 deficiency anemia, unspecified
Use when the cause of B12 deficiency is unclear or not documented.
Excludes
- Pernicious anemia (D51.0)
Clinical Validation Requirements
- Low serum B12 without intrinsic factor deficiency confirmation
Coding Notes
Query provider if documentation is unclear about intrinsic factor deficiency.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Anemia in chronic kidney disease
D63.1Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Pernicious Anemia to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code D51.0.
Impact
Clinical: Misdiagnosis of anemia type., Regulatory: Non-compliance with coding standards., Financial: Potential for incorrect billing and reimbursement.
Mitigation Strategy
Ensure lab tests are ordered and results documented., Educate providers on documentation standards.
Impact
Reimbursement: Incorrect DRG assignment leading to potential underpayment., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data affecting patient records.
Mitigation Strategy
Ensure documentation includes intrinsic factor antibody test results.
Impact
Using D51.9 instead of D51.0 when intrinsic factor deficiency is confirmed.
Mitigation Strategy
Regular audits and provider education on documentation requirements.
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 Pernicious Anemia, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Pernicious Anemia
Use these documentation templates to ensure complete and accurate documentation for Pernicious Anemia. These templates include all required elements for proper coding and billing.
Diagnosis of Pernicious Anemia
Specialty: HematologyRequired Elements
- Symptoms of anemia
- Lab results: B12, MMA, IFBA
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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