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ICD-10 Guide
ICD-10 CodesD57.2

D57.2

Billable

Sickle-cell/Hb-C disease

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

Code Description

ICD-10 D57.2 is a billable code used to indicate a diagnosis of sickle-cell/hb-c disease.

Key Diagnostic Point:

Sickle-cell/Hb-C disease is a genetic blood disorder characterized by the presence of abnormal hemoglobin, specifically hemoglobin C, which leads to the distortion of red blood cells into a sickle shape. This condition is a type of hemolytic anemia, where the sickle-shaped cells are fragile and prone to rupture, resulting in a reduced lifespan of red blood cells. Patients may experience episodes of pain due to vaso-occlusive crises, increased susceptibility to infections, and various complications affecting organs such as the spleen, liver, and lungs. The disease is inherited in an autosomal recessive pattern, meaning that both parents must carry the gene for a child to be affected. Diagnosis is typically confirmed through hemoglobin electrophoresis, which identifies the types of hemoglobin present in the blood. Management includes pain control, hydration, and preventive measures against infections, along with regular monitoring for complications. Understanding the genetic basis and clinical manifestations of sickle-cell/Hb-C disease is crucial for effective treatment and management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Requires understanding of genetic inheritance patterns.
  • Differentiation from other hemoglobinopathies.
  • Management of associated complications.
  • Need for precise documentation of clinical manifestations.

Audit Risk Factors

  • Inadequate documentation of genetic testing results.
  • Failure to document complications associated with the disease.
  • Misclassification of the type of hemoglobinopathy.
  • Inconsistent coding of related conditions.

Specialty Focus

Medical Specialties

Hematology

Documentation Requirements

Detailed lab results, family history, and clinical manifestations.

Common Clinical Scenarios

Management of pain crises, blood transfusions, and monitoring for organ damage.

Billing Considerations

Ensure accurate documentation of hemoglobin types and any complications.

Pediatrics

Documentation Requirements

Growth and development assessments, vaccination history, and family history of sickle cell disease.

Common Clinical Scenarios

Routine check-ups, management of infections, and pain management in children.

Billing Considerations

Focus on developmental milestones and preventive care.

Coding Guidelines

Inclusion Criteria

Use D57.2 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate documentation of the patient's condition, including any complications or related conditions
  • Include details from lab tests confirming the diagnosis

Exclusion Criteria

Do NOT use D57.2 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

36415CPT Code

Collection of venous blood by venipuncture

Clinical Scenario

Used for routine blood tests to monitor hemoglobin levels.

Documentation Requirements

Document the reason for blood draw and any relevant clinical findings.

Specialty Considerations

Ensure that the specialty performing the procedure is noted.

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 diseases, improving the accuracy of data collection and reimbursement processes. It has also facilitated better tracking of patient outcomes and management strategies.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of sickle-cell diseases, improving the accuracy of data collection and reimbursement processes. It has also facilitated better tracking of patient outcomes and management strategies.

Reimbursement & Billing Impact

reimbursement processes. It has also facilitated better tracking of patient outcomes and management strategies.

Resources

Clinical References

  • •
    CDC Sickle Cell Disease Resources

Coding & Billing References

  • •
    CDC Sickle Cell Disease Resources

Frequently Asked Questions

What is the difference between sickle-cell disease and sickle-cell trait?

Sickle-cell disease is a serious condition where an individual has two copies of the sickle-cell gene, leading to significant health issues. In contrast, sickle-cell trait occurs when an individual has one copy of the gene and typically does not experience symptoms.