D63.1 ICD-10-CM Code: Anemia in chronic kidney disease
D63.1 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · HCC coding software
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FY 2026 Apr update / Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism (D50-D89) / Aplastic and other anemias and other bone marrow failure syndromes (D60-D64)
D63.1
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceAnemia in chronic kidney disease
Low red blood cell count that develops in patients with chronic kidney disease due to reduced production of erythropoietin.
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
HistoricalHistorical
Not used for CY2026 payment
ACA/HHS
N/A—
Not mapped
ESRD/PACE
N/A—
Not mapped
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
Official- Erythropoietin resistant anemia (EPO resistant anemia)
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for D63.1 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for D63.1 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for D63.1 in this effective period.
Code First
Official- underlying chronic kidney disease (CKD) (N18.-)
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for D63.1 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for D63.1 in this effective period.
Buddy Documentation Tip
Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →
Is D63.1 an HCC code?
No. D63.1 is a billable ICD-10-CM code with no mapping under the CMS-HCC V28 or V24 community payment models, and none under the ESRD, Part D RxHCC, or HHS-HCC models.
- Code
- D63.1
- Description
- Anemia in chronic kidney disease
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF reference coefficient
- —
- Billable
- Yes
- Payment year
- 2026
Coder workflow notes
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This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
D63.1 is the ICD-10-CM diagnosis code for anemia in chronic kidney disease. Low red blood cell count that develops in patients with chronic kidney disease due to reduced production of erythropoietin. D63.1 sits in the ICD-10-CM chapter for diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism (d50-d89), within the section covering aplastic and other anemias and other bone marrow failure syndromes (d60-d64).
D63.1 is a billable ICD-10-CM code, but the current payload does not show a mapping under the CMS-HCC V28 or V24 community payment models, and none under the ESRD, Part D RxHCC, or HHS-HCC models. Do not assign risk adjustment value from this page when no source-backed mapping is shown; verify the applicable model and payment year.
Always link to the chronic kidney disease code (N18.1-N18.6) as the primary condition.
HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for D63.1 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
Code First
- underlying chronic kidney disease (CKD) (N18.-)