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v1.0.0
ICD-10 Guide
ICD-10 CodesD57.451

D57.451

Billable

Sickle-cell thalassemia beta plus with acute chest syndrome

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

Code Description

ICD-10 D57.451 is a billable code used to indicate a diagnosis of sickle-cell thalassemia beta plus with acute chest syndrome.

Key Diagnostic Point:

Sickle-cell thalassemia beta plus is a complex hemoglobinopathy resulting from the combination of sickle cell disease and beta-thalassemia. This condition is characterized by the presence of both sickle hemoglobin (HbS) and reduced production of beta-globin chains, leading to a mixed phenotype of sickle cell disease and thalassemia. Acute chest syndrome (ACS) is a severe complication of sickle cell disease, presenting with chest pain, fever, and respiratory symptoms, often due to pulmonary vaso-occlusion, infection, or fat embolism. Patients with D57.451 may experience recurrent episodes of ACS, which can lead to significant morbidity and mortality. Management typically involves supportive care, pain management, and treatment of underlying causes, such as antibiotics for infections. Genetic factors play a crucial role in the severity and frequency of complications, as the specific mutations in the beta-globin gene can influence the clinical presentation and response to treatment.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Combination of two genetic disorders (sickle cell disease and beta-thalassemia)
  • Variability in clinical presentation and severity among patients
  • Need for precise documentation of acute chest syndrome episodes
  • Potential for overlapping symptoms with other respiratory conditions

Audit Risk Factors

  • Inadequate documentation of acute chest syndrome episodes
  • Failure to specify the type of thalassemia
  • Misclassification of symptoms as unrelated respiratory issues
  • Lack of genetic testing documentation

Specialty Focus

Medical Specialties

Hematology

Documentation Requirements

Detailed patient history, genetic testing results, and treatment plans.

Common Clinical Scenarios

Management of acute chest syndrome, blood transfusions, and hydroxyurea therapy.

Billing Considerations

Ensure documentation reflects the severity of symptoms and treatment responses.

Pulmonology

Documentation Requirements

Pulmonary function tests, imaging studies, and treatment for respiratory symptoms.

Common Clinical Scenarios

Evaluation of respiratory distress in patients with sickle cell disease.

Billing Considerations

Document any acute exacerbations and their management thoroughly.

Coding Guidelines

Inclusion Criteria

Use D57.451 When
  • Follow the official ICD
  • CM coding guidelines for coding hemolytic anemias and acute conditions
  • Ensure that documentation supports the diagnosis, including the presence of acute chest syndrome and the specific type of thalassemia

Exclusion Criteria

Do NOT use D57.451 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

36430CPT Code

Transfusion, blood or blood components

Clinical Scenario

Used during hospitalization for acute chest syndrome management.

Documentation Requirements

Document the reason for transfusion and patient response.

Specialty Considerations

Hematology specialists should ensure accurate coding of transfusion episodes.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of complex conditions like sickle-cell thalassemia beta plus, improving the accuracy of patient records and reimbursement processes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of complex conditions like sickle-cell thalassemia beta plus, improving the accuracy of patient records and reimbursement processes.

Reimbursement & Billing Impact

reimbursement processes.

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 D57.451?

Coding D57.451 accurately reflects the complexity of managing patients with both sickle-cell disease and thalassemia, particularly when acute complications arise, ensuring appropriate treatment and reimbursement.