ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 D53.1

Billable / Specific

Other megaloblastic anemias, not elsewhere classified

D53
Block
1
Synonyms
33
LCDs
8
Payer Policies
2
Linked CPTs

About ICD-10-CM D53.1

ICD-10-CM code D53.1 represents Other megaloblastic anemias, not elsewhere classified. This is a billable/specific code in the Blood and Blood-forming Organs chapter (block D53). The 2026 edition of ICD-10-CM D53.1 became effective on October 1, 2025.

Inclusion Terms / Approximate Synonyms

Clinical terms and conditions classified under D53.1. Per CMS ICD-10-CM Tabular 2026.

  • Megaloblastic anemia NOS

Type 1 Excludes

Pure excludes, these codes can never be coded together with D53.1. The conditions are mutually exclusive (e.g., congenital vs acquired forms).

  • Di Guglielmo's disease (C94.0)

Medicare LCD Coverage for D53.1

Local Coverage Determinations (LCDs) from CMS MACs that list D53.1 as a covered diagnosis.

33 LCDs

Showing top 10 of 33 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Homocysteine Level, Serum
Article ID: 56675, Effective: 2024-10-01 00:00:00, 550 covered, 0 non-covered
CPT 83090 →
CMS LCD: Billing and Coding: Assays for Vitamins and Metabolic Function
Article ID: 56416, Effective: 2025-10-01 00:00:00, 899 covered, 1 non-covered
CPT 82306 →
CMS LCD: Billing and Coding: Assays for Vitamins and Metabolic Function
Article ID: 56416, Effective: 2025-10-01 00:00:00, 899 covered, 1 non-covered
CPT 82607 →
CMS LCD: Billing and Coding: Assays for Vitamins and Metabolic Function
Article ID: 56416, Effective: 2025-10-01 00:00:00, 899 covered, 1 non-covered
CPT 82746 →
CMS LCD: Billing and Coding: Assays for Vitamins and Metabolic Function
Article ID: 56416, Effective: 2025-10-01 00:00:00, 899 covered, 1 non-covered
CPT 85385 →
CMS LCD: Billing and Coding: Assays for Vitamins and Metabolic Function
Article ID: 56416, Effective: 2025-10-01 00:00:00, 899 covered, 1 non-covered
CPT 83090 →
CMS LCD: Billing and Coding: Assays for Vitamins and Metabolic Function
Article ID: 56416, Effective: 2025-10-01 00:00:00, 899 covered, 1 non-covered
CPT 82652 →
CMS LCD: Billing and Coding: Assays for Vitamins and Metabolic Function
Article ID: 56416, Effective: 2025-10-01 00:00:00, 899 covered, 1 non-covered
CPT 84207 →
CMS LCD: Billing and Coding: Assays for Vitamins and Metabolic Function
Article ID: 56416, Effective: 2025-10-01 00:00:00, 899 covered, 1 non-covered
CPT 86352 →
CMS LCD: Billing and Coding: Assays for Vitamins and Metabolic Function
Article ID: 56416, Effective: 2025-10-01 00:00:00, 899 covered, 1 non-covered
CPT 82379 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing D53.1.

8 policies

2 Cigna

Flow Cytometry - (0538)
Policy ID: MM_0538
Serum Folate and Red Blood Cell Folate Testing - (0567)
Policy ID: MM_0567

5 Medicare

Billing and Coding: Assays for Vitamins and Metabolic Function
Policy ID: ART-56416
Billing and Coding: Flow Cytometry
Policy ID: ART-56464
Billing and Coding: Homocysteine Level, Serum
Policy ID: ART-56675
Billing and Coding: Routine Foot Care
Policy ID: ART-57188
Billing and Coding: Vitamin B<sub>12</sub> Injections
Policy ID: ART-57755

1 Aetna

Vitamin B-12 Therapy
Policy ID: CPB-0536

CPT Codes Commonly Billed with D53.1

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

2 linkages
  • J3420 CMS LCD: Billing and Coding: Vitamin B<sub>12</sub> Injections CMS LCD
  • J3425 CMS LCD: Billing and Coding: Vitamin B<sub>12</sub> Injections CMS LCD

Convert D53.1 to ICD-9-CM

Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.

ICD-10ICD-9Mapping Flags
D53.1 2813 00000

Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).

ICD-10 D53.1, Billing FAQ

Is ICD-10 code D53.1 billable? +

Yes, D53.1 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What other names or terms map to D53.1? +

ICD-10 D53.1 includes: Megaloblastic anemia NOS.

What codes are Type 1 Excludes for D53.1? +

Type 1 Excludes (never code together with D53.1): Di Guglielmo's disease (C94.0)

What CPT codes are commonly billed with D53.1? +

Procedures frequently paired with D53.1 include: J3420, J3425.

What ICD-9 codes does D53.1 map to? +

Per CMS GEMs, D53.1 maps to ICD-9 codes: 2813. Useful for legacy data review and historical claim analysis.

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Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on June 1, 2026.

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