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ICD-10 Guide
ICD-10 CodesD56.3

D56.3

Billable

Thalassemia minor

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/05/2025

Code Description

ICD-10 D56.3 is a billable code used to indicate a diagnosis of thalassemia minor.

Key Diagnostic Point:

Thalassemia minor, also known as beta-thalassemia trait, is a genetic blood disorder characterized by a reduced production of hemoglobin, the protein in red blood cells that carries oxygen. Individuals with thalassemia minor typically have mild anemia and may not exhibit significant clinical symptoms. The condition is inherited in an autosomal recessive pattern, meaning that a person must inherit two copies of the mutated gene (one from each parent) to develop more severe forms of thalassemia. In thalassemia minor, patients often present with microcytic anemia, which can be misdiagnosed as iron deficiency anemia. Laboratory findings typically include a low mean corpuscular volume (MCV) and mean corpuscular hemoglobin (MCH), along with normal iron studies. Genetic testing can confirm the diagnosis by identifying mutations in the HBB gene. While thalassemia minor is generally considered a benign condition, it is important for affected individuals to be aware of their carrier status, especially when planning for pregnancy, as there is a risk of having children with more severe forms of thalassemia if both parents are carriers.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiation from iron deficiency anemia
  • Need for genetic testing documentation
  • Variability in clinical presentation
  • Potential for misdiagnosis

Audit Risk Factors

  • Inadequate documentation of genetic testing
  • Misclassification as more severe thalassemia
  • Failure to document family history
  • Inconsistent lab results interpretation

Specialty Focus

Medical Specialties

Hematology

Documentation Requirements

Detailed lab results, genetic testing outcomes, and patient history.

Common Clinical Scenarios

Patients presenting with mild anemia, family history of thalassemia, or abnormal hemoglobin electrophoresis.

Billing Considerations

Ensure that genetic counseling and testing results are documented to support the diagnosis.

Genetics

Documentation Requirements

Family pedigree, genetic test results, and counseling notes.

Common Clinical Scenarios

Couples seeking genetic counseling for family planning when both are carriers of thalassemia minor.

Billing Considerations

Documentation of carrier status and potential risks to offspring is crucial.

Coding Guidelines

Inclusion Criteria

Use D56.3 When
  • According to ICD
  • 10 guidelines, thalassemia minor is classified under D56
  • It is important to document the patient's clinical presentation, lab results, and any genetic testing performed

Exclusion Criteria

Do NOT use D56.3 When
  • Exclude codes for more severe forms of thalassemia unless applicable

Related ICD-10 Codes

Related CPT Codes

81291CPT Code

Hemoglobinopathy testing

Clinical Scenario

Used when genetic testing is performed to confirm thalassemia minor.

Documentation Requirements

Document the reason for testing and the results.

Specialty Considerations

Hematology specialists should ensure comprehensive documentation of test results.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of thalassemia minor, improving the accuracy of diagnoses and treatment plans. It emphasizes the importance of genetic testing and documentation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of thalassemia minor, improving the accuracy of diagnoses and treatment plans. It emphasizes the importance of genetic testing and documentation.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of thalassemia minor, improving the accuracy of diagnoses and treatment plans. It emphasizes the importance of genetic testing and documentation.

Resources

Clinical References

  • •
    Thalassemia International Federation

Coding & Billing References

  • •
    Thalassemia International Federation

Frequently Asked Questions

What is thalassemia minor?

Thalassemia minor is a genetic blood disorder characterized by mild anemia due to reduced hemoglobin production. It is often asymptomatic and diagnosed through blood tests and genetic testing.