2026 ICD-10-CM Diagnosis Code D64.3Other sideroblastic anemias

ICD-10-CM Codes›D50–D89›D60-D64›D64

ICD-10-CM D64.3
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

D64.3 is a billable ICD-10-CM diagnosis code for other sideroblastic anemias. 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. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Aplastic anemia.

For Medicare Advantage risk adjustment, D64.3 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

ICD-10-CM Code
D64.3
Billable Status
Yes — Valid for Submission
Code Describes
Other sideroblastic anemias
Short Description
Other sideroblastic anemias
Same as the full description in the CMS dataset.
Parent Code
D64
Other anemias

Code Classification

ChapterD50–D89Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism
SectionD60-D64Aplastic and other anemias and other bone marrow failure syndromes
CategoryD64Other anemias
This CodeD64.3Other sideroblastic anemias

Medicare Risk Adjustment (HCC)Billing

D64.3 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.

CMS-HCC V28 Category (Payment Model)
HCC 109— Acquired Hemolytic, Aplastic, and Sideroblastic Anemias
Payment HCC · PY 2026 one of 37 ICD-10-CM codes in this category
Risk Adjustment Factor (RAF) Weight
+1.144
community, non-dual, aged · ranges 0.529–1.815 across segments
Hierarchy
Top of its hierarchy
HCC 109 is not superseded by any other condition category
Prior Model (CMS-HCC V24)
HCC 48
V24 retired V28 pays 100% of MA risk scores since PY 2026
Other CMS Models
PACE (CMS-HCC V22): HCC 48 · ESRD (V21): HCC 48 · ESRD (V24): HCC 48
ESRD V21 weights: 0.059 dialysis, 0.173–0.234 functioning graft · ESRD V24 weights: 0.063 dialysis, 0.192–0.358 functioning graft
Part D (RxHCC)
RxHCC 96 — Acquired Hemolytic, Aplastic, and Sideroblastic Anemias
also risk-adjusts in the Part D prescription drug model (V08)

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.

  • Autosomal-linked pyridoxine refractory sideroblastic anemia
  • Fetal acidosis
  • Fetal anemia
  • Fetal metabolic disorder
  • Hydrops fetalis
  • Hydrops, lactic acidosis, sideroblastic anemia, multisystemic failure syndrome
  • Idiopathic sideroblastic anemia
  • Pyridoxine-responsive sideroblastic anemia
  • Secondary acquired sideroblastic anemia
  • Sideroblastic anemia
  • X chromosome-linked pyridoxine responsive sideroblastic anemia
  • X chromosome-linked sideroblastic anemia

Tabular List NotesGuidance

Coding notes and annotation back-references applicable to this code.

Inclusion Terms

  • Sideroblastic anemia NOS
  • Pyridoxine-responsive sideroblastic anemia NEC

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.

CCSR BLD003
Aplastic anemia
Default principal diagnosis: inpatient Yes · outpatient Yes

Clinical InformationClinical

  • Hydrops Fetalis

    abnormal accumulation of serous fluid in two or more fetal compartments, such as skin; pleura; pericardium; placenta; peritoneum; amniotic fluid. general fetal edema may be of non-immunologic origin, or of immunologic origin as in the case of erythroblastosis fetalis.

  • Hydrops Fetalis

    a condition characterized by fluid accumulation in two or more anatomic compartments in the fetus.

  • Immune Hydrops Fetalis

    fluid accumulation in multiple fetal anatomic cavities attributable to a maternal immune response against fetal blood cell antigens.

  • Non-Immune Hydrops Fetalis

    fluid accumulation in multiple fetal anatomic cavities that is of non-immune origin.

  • Hereditary Sideroblastic Anemia

    an inherited form of sideroblastic anemia.

  • Myelodysplastic Syndrome with Ring Sideroblasts|MDS-RS|Pure Sideroblastic Anemia|RARS|RARS|Refractory Anemia with Ring Sideroblasts|Refractory Anemia with Ringed Sideroblasts|Refractory anemia with ring sideroblasts|Refractory anemia with ringed sideroblasts

    a myelodysplastic syndrome characterized by an anemia in which 15% or more of the erythroid precursors are ring sideroblasts. the ring sideroblast is an erythroid precursor in which one third or more of the nucleus is encircled by granules which are positive for iron stain. (who, 2001)

  • Sideroblastic Anemia

    anemia characterized by the production of ringed sideroblasts instead of healthy red blood cells.

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 D64.3 to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
285.0 Sideroblastic anemia
Approximate The match is approximate rather than exact.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2025No changes
FY 2026CurrentCurrent code set, no changesEffective October 1, 2025 through September 30, 2026.

Questions About D64.3Overview

What is the ICD-10 code for other sideroblastic anemias?

The ICD-10-CM code for other sideroblastic anemias is D64.3 (sometimes written as D643). It is billable on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

Is D64.3 (Other anemias) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report other sideroblastic anemias on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

What MS-DRG does D64.3 group to?

When other sideroblastic anemias 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 D64.3?

Under the General Equivalence Mappings, other sideroblastic anemias converts to ICD-9-CM 285.0 (sideroblastic anemia). The mapping is approximate, so confirm the match fits the documentation.

What HCC is D64.3?

D64.3 (other sideroblastic anemias) 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 D64.3 risk-adjust for Medicare Advantage payment?

Yes. When documented and reported on a Medicare Advantage encounter, D64.3 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.