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ICD-10 Guide
ICD-10 CodesD57.03

D57.03

Billable

Hb-SS disease with cerebral vascular involvement

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

Code Description

ICD-10 D57.03 is a billable code used to indicate a diagnosis of hb-ss disease with cerebral vascular involvement.

Key Diagnostic Point:

Hb-SS disease, also known as sickle cell disease, is a genetic blood disorder characterized by the presence of hemoglobin S (HbS) which causes red blood cells to become rigid and sickle-shaped. This abnormal shape leads to various complications, including hemolytic anemia, vaso-occlusive crises, and increased risk of infections. When cerebral vascular involvement occurs, it indicates that the sickle-shaped cells are obstructing blood flow in the cerebral vasculature, potentially leading to strokes or transient ischemic attacks (TIAs). Patients may present with neurological deficits, headaches, or seizures. The management of Hb-SS disease with cerebral vascular involvement often requires a multidisciplinary approach, including pain management, hydration, and possibly blood transfusions to reduce the risk of further complications. Genetic factors play a crucial role in the disease's manifestation, as it is inherited in an autosomal recessive pattern. Understanding the complexities of this condition is essential for accurate diagnosis and treatment.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Requires understanding of genetic inheritance patterns
  • Involves multiple organ systems and complications
  • Differentiation from other types of sickle cell disease
  • Need for comprehensive documentation of neurological involvement

Audit Risk Factors

  • Inadequate documentation of neurological symptoms
  • Failure to specify the type of cerebral vascular event
  • Misclassification of sickle cell disease type
  • Lack of evidence for genetic testing

Specialty Focus

Medical Specialties

Hematology

Documentation Requirements

Detailed history of sickle cell disease, including previous crises and treatments.

Common Clinical Scenarios

Management of pain crises, blood transfusions, and monitoring for stroke.

Billing Considerations

Ensure documentation reflects the severity and frequency of complications.

Neurology

Documentation Requirements

Neurological assessments, imaging results, and treatment plans for stroke or TIA.

Common Clinical Scenarios

Evaluation of stroke symptoms in patients with known sickle cell disease.

Billing Considerations

Document the relationship between sickle cell disease and neurological findings.

Coding Guidelines

Inclusion Criteria

Use D57.03 When
  • Follow the ICD
  • CM guidelines for coding sickle cell disease and associated complications
  • Ensure that documentation supports the diagnosis of cerebral vascular involvement and any related symptoms

Exclusion Criteria

Do NOT use D57.03 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

36430CPT Code

Transfusion, blood or blood components

Clinical Scenario

Used during management of severe anemia or stroke in sickle cell patients.

Documentation Requirements

Document the indication for transfusion and patient response.

Specialty Considerations

Hematology specialists should ensure compliance with transfusion protocols.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of sickle cell disease and its complications, improving the accuracy of patient records and facilitating better management of the disease.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of sickle cell disease and its complications, improving the accuracy of patient records and facilitating better management of the disease.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of sickle cell disease and its complications, improving the accuracy of patient records and facilitating better management of the disease.

Resources

Clinical References

  • •
    Sickle Cell Disease Association of America

Coding & Billing References

  • •
    Sickle Cell Disease Association of America

Frequently Asked Questions

What is the significance of coding D57.03?

Coding D57.03 accurately reflects the severity of sickle cell disease with cerebral vascular involvement, which is crucial for appropriate treatment and management, as well as for insurance reimbursement.