2025 ICD-10-CM code D64.2
(Valid) Effective Date: N/A Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism - Aplastic and other anemias and other bone marrow failure syndromes Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism (D50-D89) Feed
Secondary sideroblastic anemia due to drugs and toxins.
Medical necessity is established by the presence of signs, symptoms, and laboratory findings consistent with sideroblastic anemia, along with evidence of a causative drug or toxin exposure. The medical record should clearly demonstrate the link between the anemia and the causative agent.
A patient suffering from secondary sideroblastic anemia due to drugs and toxins may experience fatigue, weakness, paleness, shortness of breath, sensation of racing heartbeat, chest pain, irritability, and at times, enlarged spleen and liver, along with symptoms specific to the organ affected. Provider diagnoses the condition based on history, physical examination, and signs and symptoms. Laboratory tests include CBC, peripheral smear, and iron levels. Other tests such as bone marrow biopsy may be helpful. Usually, discontinuation of the drug or therapy reverses the changes. Treatment includes vitamin B6 (pyridoxine) therapy, blood transfusions, and bone marrow transplantation.
- Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism (D50-D89)
- D60-D64
In simple words: This condition is a type of anemia where the bone marrow produces abnormal red blood cells due to exposure to certain drugs or toxins like zinc, lead, some antibiotics, hormones, or chemotherapy drugs.This leads to a lack of oxygen in the blood and symptoms like fatigue, weakness, and shortness of breath.
Secondary sideroblastic anemia due to drugs and toxins refers to a disorder of the bone marrow in which there is production of abnormal red blood cells (RBCs), characterized by ring-like accumulation of iron in the nucleus. It can be caused due to an overdose of zinc, lead poisoning, and certain drugs such as antibiotics, hormones, and chemotherapy agents.
Example 1: A patient receiving chemotherapy for breast cancer develops fatigue, shortness of breath, and pallor. Blood tests reveal low hemoglobin and a bone marrow biopsy shows ringed sideroblasts. The diagnosis is secondary sideroblastic anemia due to chemotherapy., A child with a history of pica presents with abdominal pain, fatigue, and developmental delays.Blood tests show anemia and elevated lead levels.Further investigation reveals ringed sideroblasts in the bone marrow, confirming secondary sideroblastic anemia due to lead poisoning. , An individual taking high doses of zinc supplements for an extended period develops weakness, paleness, and shortness of breath.Laboratory findings indicate anemia, and a bone marrow examination reveals ringed sideroblasts, leading to a diagnosis of secondary sideroblastic anemia due to zinc toxicity.
Documentation should include the type of anemia, evidence of drug or toxin exposure (e.g., medication list, environmental exposure history, lab results), and clinical manifestations (e.g., fatigue, shortness of breath, pallor). Lab findings such as CBC, iron studies, and bone marrow biopsy results should also be documented. If a specific drug is implicated, it should be clearly identified.
** Excludes1: refractory anemia (D46.-) and refractory anemia with excess blasts in transformation [RAEB T] (C92.0-). Excludes2: 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).
- Specialties:Hematology, Oncology, Internal Medicine, Pediatrics
- Place of Service:Inpatient Hospital, Outpatient Hospital, Office, Independent Clinic