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2025 ICD-10-CM code D55

Anemia due to enzyme disorders.

Do not code drug-induced enzyme deficiency anemia (D59.2) with D55.

Medical necessity is established by the presence of signs and symptoms of anemia, along with laboratory confirmation of an enzyme deficiency affecting red blood cell function.The documentation should clearly link the enzyme deficiency to the clinical presentation of anemia.

Clinicians diagnose this condition through patient history, physical examination, and assessment of symptoms like fever, weakness, fatigue, shortness of breath, palpitations, dark urine, yellowing of skin, and enlarged spleen.Laboratory tests such as complete blood count (CBC) and reticulocyte count are essential for diagnosis.Treatment involves addressing the underlying cause, potentially including discontinuing certain medications or treating infections.Severe cases might necessitate blood transfusions.

In simple words: Anemia caused by a shortage of enzymes needed for healthy red blood cells. This can lead to the early breakdown of red blood cells, reducing their number and oxygen-carrying capacity.

A decrease in red blood cells (RBCs) resulting in reduced oxygen levels due to the lack of crucial enzymes like glucose-6-phosphate dehydrogenase, glutathione, and nucleotide and glycolytic enzymes.These enzyme deficiencies, often caused by genetic abnormalities, lead to premature destruction of red blood cells (hemolysis), resulting in anemia.

Example 1: A patient presents with fatigue, shortness of breath, and jaundice after taking a course of antibiotics.Lab tests reveal a low red blood cell count and confirm G6PD deficiency, indicating anemia due to enzyme disorder., A newborn develops jaundice shortly after birth.Tests reveal a deficiency in G6PD, diagnosing the infant with anemia due to an enzyme disorder.Phototherapy is administered to manage the jaundice., A patient with a family history of anemia experiences chronic fatigue and pallor.Following a comprehensive blood workup, including enzyme assays, they are diagnosed with pyruvate kinase deficiency, a type of anemia due to enzyme disorder.

Thorough documentation should include patient history, family history of anemia, symptoms, physical examination findings (e.g., pallor, jaundice, splenomegaly), medication history, and laboratory results including CBC, reticulocyte count, and enzyme assays (e.g., G6PD, pyruvate kinase). Document the specific enzyme deficiency if identified.

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