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ICD-10 Guide
ICD-10 CodesD57.212

D57.212

Billable

Sickle-cell/Hb-C disease with splenic sequestration

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

Code Description

ICD-10 D57.212 is a billable code used to indicate a diagnosis of sickle-cell/hb-c disease with splenic sequestration.

Key Diagnostic Point:

Sickle-cell/Hb-C disease with splenic sequestration is a complex hemolytic anemia characterized by the presence of both sickle hemoglobin (HbS) and hemoglobin C (HbC). This condition arises from mutations in the HBB gene, leading to the production of abnormal hemoglobin that distorts red blood cells into a sickle shape, causing them to become rigid and sticky. In splenic sequestration, these sickled cells can obstruct blood flow in the spleen, leading to acute splenic enlargement and a sudden drop in hemoglobin levels. Patients may present with symptoms such as severe abdominal pain, fatigue, pallor, and signs of shock due to rapid blood loss. The condition is particularly prevalent in individuals of African and Mediterranean descent. Management often involves hydration, pain control, and blood transfusions, with the potential for splenectomy in recurrent cases. Understanding the genetic basis and clinical implications of this disease is crucial for effective treatment and management.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Multiple genetic factors involved in the disease
  • Variability in clinical presentation and severity
  • Need for precise documentation of splenic sequestration events
  • Differentiation from other hemolytic anemias

Audit Risk Factors

  • Inadequate documentation of splenic sequestration events
  • Failure to document the severity of anemia
  • Misclassification of related hemolytic anemias
  • Inconsistent coding of co-morbid conditions

Specialty Focus

Medical Specialties

Hematology

Documentation Requirements

Detailed lab results, genetic testing outcomes, and clinical notes on splenic function.

Common Clinical Scenarios

Management of acute splenic sequestration crises and chronic anemia management.

Billing Considerations

Ensure comprehensive documentation of all symptoms and treatments to support coding.

Pediatrics

Documentation Requirements

Growth and development assessments, family history of hemoglobinopathies.

Common Clinical Scenarios

Routine monitoring of children with sickle-cell disease and management of pain crises.

Billing Considerations

Documenting developmental milestones and any complications related to sickle-cell disease.

Coding Guidelines

Inclusion Criteria

Use D57.212 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate documentation of the condition's severity and any associated complications
  • Include details of splenic sequestration events and any treatments administered

Exclusion Criteria

Do NOT use D57.212 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

36430CPT Code

Transfusion, blood or blood components

Clinical Scenario

Used during acute splenic sequestration management.

Documentation Requirements

Document the need for transfusion due to anemia severity.

Specialty Considerations

Hematology specialists should ensure transfusion protocols are followed.

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, including the differentiation of splenic sequestration, which enhances the accuracy of patient records and treatment plans.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of sickle-cell diseases, including the differentiation of splenic sequestration, which enhances the accuracy of patient records and treatment plans.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of sickle-cell diseases, including the differentiation of splenic sequestration, which enhances the accuracy of patient records and treatment plans.

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 splenic sequestration in sickle-cell disease?

Splenic sequestration is a critical complication of sickle-cell disease that can lead to severe anemia and requires immediate medical attention. It is characterized by the trapping of sickled red blood cells in the spleen, leading to splenomegaly and a rapid drop in hemoglobin levels.