2026 ICD-10-CM Diagnosis Code D64.0Hereditary sideroblastic anemia
ICD-10-CM Codes›D50–D89›D60-D64›D64
- Billable — Valid for Submission
- Risk Adjusts — HCC 109
- Chronic Condition
D64.0 is a billable ICD-10-CM diagnosis code for hereditary sideroblastic anemia. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 811 through 812. Coders also document this condition as adult-onset autosomal recessive sideroblastic anemia. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Aplastic anemia.
For Medicare Advantage risk adjustment, D64.0 maps to CMS-HCC Category 109 (Acquired Hemolytic, Aplastic, and Sideroblastic Anemias) under the V28 model, adding a risk factor of about 1.144 for a community, non-dual, aged beneficiary in payment year 2026.
Code Identity
Code Classification
Medicare Risk Adjustment (HCC)Billing
D64.0 maps to a payment category in the CMS-HCC model used to risk-adjust Medicare Advantage payments. Weights are the published community factors for payment year 2026.
Source: CMS Payment Year 2026 risk adjustment mappings and model software. Weights are relative factors, not dollar amounts; a beneficiary's total RAF also includes demographics and interactions. Browse all CMS-HCC categories.
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Adult-onset autosomal recessive sideroblastic anemia
- Autosomal dominant sideroblastic anemia
- Autosomal recessive sideroblastic anemia
- Congenital sideroblastic anemia, B-cell immunodeficiency, periodic fever, developmental delay syndrome
- Mitochondrial myopathy with sideroblastic anemia syndrome
- Severe congenital hypochromic anemia with ringed sideroblasts
- X chromosome-linked sideroblastic anemia
- X-linked sideroblastic anemia with spinocerebellar ataxia
Tabular List NotesGuidance
Coding notes and annotation back-references applicable to this code.
Inclusion Terms
- Sex-linked hypochromic sideroblastic anemia
These terms are the conditions for which that code is to be used. The terms may be synonyms of the code title, or, in the case of "other specified" codes, the terms are a list of the various conditions assigned to that code. The inclusion terms are not necessarily exhaustive. Additional terms found only in the Alphabetic Index may also be assigned to a code.
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Clinical InformationClinical
Hereditary Sideroblastic Anemia
an inherited form of sideroblastic anemia.
Patient EducationClinical
Anemia
If you have anemia, your blood does not carry enough oxygen to the rest of your body. The most common cause of anemia is not having enough iron. Your body needs iron to make hemoglobin. Hemoglobin is an iron-rich protein that gives the red color to blood. It carries oxygen from the lungs to the rest of the body.
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert D64.0 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About D64.0Overview
What is the ICD-10 code for hereditary sideroblastic anemia?
The ICD-10-CM code for hereditary sideroblastic anemia is D64.0 (sometimes written as D640). It is billable on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
Is D64.0 (Other anemias) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report hereditary sideroblastic anemia on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
What MS-DRG does D64.0 group to?
When hereditary sideroblastic anemia is the principal diagnosis on an inpatient stay, it groups to MS-DRG 811, 812, with relative weights from 0.9182 to 1.4043 depending on complications. Higher weights mean higher Medicare reimbursement.
What is the ICD-9 equivalent of D64.0?
Under the General Equivalence Mappings, hereditary sideroblastic anemia converts to ICD-9-CM 285.0 (sideroblastic anemia). The mapping is approximate, so confirm the match fits the documentation.
What HCC is D64.0?
D64.0 (hereditary sideroblastic anemia) maps to CMS-HCC Category 109 (Acquired Hemolytic, Aplastic, and Sideroblastic Anemias), commonly written as HCC 109, in the CMS-HCC V28 model used for Medicare Advantage risk adjustment in payment year 2026. It mapped to HCC 48 under the retired V24 model. It also maps in the PACE (CMS-HCC V22), ESRD (V21), and ESRD (V24) models. In the Part D prescription drug model it maps to RxHCC 96.
Does D64.0 risk-adjust for Medicare Advantage payment?
Yes. When documented and reported on a Medicare Advantage encounter, D64.0 adds a risk adjustment factor of about 1.144 to the beneficiary's RAF score for a community, non-dual, aged enrollee (published V28 weights range from 0.529 to 1.815 depending on the payment segment). HCC 109 sits at the top of its hierarchy, so no other condition category supersedes it. See the full factor table on the HCC 109 category page.
