2027 ICD-10-CM Diagnosis Code D64.2Secondary sideroblastic anemia due to drugs and toxins
ICD-10-CM Codes›D50–D89›D60-D64›D64
- Billable — Valid for Submission
- Not Chronic
D64.2 is a billable ICD-10-CM diagnosis code for secondary sideroblastic anemia due to drugs and toxins. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 811 through 812. Coders also document this condition as anemia caused by lead. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Aplastic anemia and Drug induced or toxic related condition.
D64.2 no longer risk-adjusts for Medicare Advantage: it mapped to HCC 48 under the retired CMS-HCC V24 model through payment year 2025 but maps to no category in the live V28 model. It still risk-adjusts in the PACE (CMS-HCC V22) category 48, ESRD (V21) category 48, ESRD (V24) category 48, and RxHCC Part D (V08) category 96 for payment year 2027.
Code Identity
Code Classification
Medicare Risk Adjustment (HCC)Billing
D64.2 no longer risk-adjusts for Medicare Advantage: it maps to no payment category in the live CMS-HCC V28 model, although it still risk-adjusts in the other CMS models shown below.
Source: CMS Payment Year 2027 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.
- Anemia caused by lead
- Drug-induced sideroblastic anemia
- Secondary acquired sideroblastic anemia
- Sideroblastic anemia caused by alcohol
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to D64.2: its own notes plus those printed at D64 and Chapter 3. A note printed at a category, block or chapter applies to every code under it.
Excludes1
Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.
Excludes2
Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.
- autoimmune disease (systemic) NOS (M35.9)
- certain conditions originating in the perinatal period (P00-P96)
- complications of pregnancy, childbirth and the puerperium (O00-O9A)
- congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)
- endocrine, nutritional and metabolic diseases (E00-E88)
- human immunodeficiency virus [HIV] disease (B20)
- injury, poisoning and certain other consequences of external causes (S00-T88)
- neoplasms (C00-D49)
- symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
Code First
The underlying condition named in the note is sequenced before this code.
Use Additional Code
Add a second code, after this one, to fully describe the condition.
Source: CMS ICD-10-CM Tabular List. How to read instructional notes.
Referenced in Other NotesGuidance
Instructional notes printed at other codes that name D64.2, its category, or a range that includes it.
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.
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
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Convert D64.2 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About D64.2Overview
What is the ICD-10 code for secondary sideroblastic anemia due to drugs and toxins?
The ICD-10-CM code for secondary sideroblastic anemia due to drugs and toxins is D64.2 (sometimes written as D642). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is D64.2 (Other anemias) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report secondary sideroblastic anemia due to drugs and toxins on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does D64.2 group to?
When secondary sideroblastic anemia due to drugs and toxins is the principal diagnosis on an inpatient stay, it groups to MS-DRG 812, 811, with relative weights from 0.9237 to 1.3991 depending on complications. Higher weights mean higher Medicare reimbursement.
Can D64.2 be reported with a code from D46?
Not as a rule. The Excludes1 note at D64, which applies to D64.2, lists "refractory anemia (D46.-)". An Excludes1 note means the excluded code is never reported together with this one; the only exception is when the two conditions are unrelated to each other (Official Guidelines, Section I.A.12.a).
Does D64.2 need an additional code?
When the condition applies, yes. The Use Additional Code note reads: code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5). The additional code is reported after D64.2.
Does D64.2 risk-adjust for Medicare Advantage payment?
Not for Medicare Advantage. D64.2 mapped to HCC 48 in the retired CMS-HCC V24 model, which last determined payment in 2025, but it maps to no category in the live V28 model; see all codes that no longer risk-adjust. It still risk-adjusts in the PACE (CMS-HCC V22) category 48 (Coagulation Defects and Other Specified Hematological Disorders), ESRD (V21) category 48 (Coagulation Defects and Other Specified Hematological Disorders), ESRD (V24) category 48 (Coagulation Defects and Other Specified Hematological Disorders), and RxHCC Part D (V08) category 96 (Acquired Hemolytic, Aplastic, and Sideroblastic Anemias).
