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ICD-10 Guide
ICD-10 CodesD57.81

D57.81

Billable

Other sickle-cell disorders with crisis

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

Code Description

ICD-10 D57.81 is a billable code used to indicate a diagnosis of other sickle-cell disorders with crisis.

Key Diagnostic Point:

D57.81 refers to other sickle-cell disorders characterized by recurrent vaso-occlusive crises, which can lead to acute pain episodes and various complications. Sickle-cell disorders are a group of inherited red blood cell disorders that result from mutations in the HBB gene, leading to the production of abnormal hemoglobin known as hemoglobin S (HbS). In these disorders, the sickle-shaped red blood cells can obstruct blood flow, causing ischemia and pain. Patients may experience hemolytic anemia due to the rapid destruction of sickle cells, leading to fatigue, pallor, and jaundice. Enzyme deficiencies, such as glucose-6-phosphate dehydrogenase deficiency, can exacerbate hemolysis and crisis episodes. Thalassemias, another group of inherited blood disorders, may coexist with sickle-cell disease, complicating the clinical picture. Genetic factors play a crucial role in the severity and frequency of crises, with some patients experiencing more frequent episodes due to additional genetic mutations. Accurate coding of D57.81 is essential for proper management and treatment of these patients, as it reflects the complexity of their condition and the need for tailored therapeutic approaches.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation among patients
  • Need for precise documentation of crisis episodes
  • Differentiation from other hemolytic anemias
  • Potential overlap with thalassemias and other genetic disorders

Audit Risk Factors

  • Inadequate documentation of crisis episodes
  • Failure to specify the type of sickle-cell disorder
  • Misclassification of related hemolytic anemias
  • Lack of genetic testing documentation

Specialty Focus

Medical Specialties

Hematology

Documentation Requirements

Detailed patient history, laboratory results, and genetic testing documentation.

Common Clinical Scenarios

Management of vaso-occlusive crises, blood transfusions, and hydroxyurea therapy.

Billing Considerations

Ensure documentation reflects the specific type of sickle-cell disorder and any associated complications.

Genetics

Documentation Requirements

Genetic testing results and family history of sickle-cell disorders.

Common Clinical Scenarios

Counseling patients on genetic risks and implications of sickle-cell disorders.

Billing Considerations

Accurate coding requires understanding of genetic mutations and their impact on disease severity.

Coding Guidelines

Inclusion Criteria

Use D57.81 When
  • Follow official ICD
  • 10 coding guidelines, ensuring accurate documentation of the type of sickle
  • cell disorder and any associated complications
  • Include details of crisis episodes and any relevant laboratory findings

Exclusion Criteria

Do NOT use D57.81 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 crisis.

Documentation Requirements

Document the reason for transfusion and patient response.

Specialty Considerations

Hematology specialists should ensure proper indication for transfusion is documented.

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 disorders, improving the ability to capture the complexity of these conditions and their management.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of sickle-cell disorders, improving the ability to capture the complexity of these conditions and their management.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of sickle-cell disorders, improving the ability to capture the complexity of these conditions and their management.

Resources

Clinical References

  • •
    Sickle Cell Disease Association of America

Coding & Billing References

  • •
    Sickle Cell Disease Association of America

Frequently Asked Questions

What is the difference between D57.81 and D57.0?

D57.81 is used for other sickle-cell disorders with crisis, while D57.0 specifically refers to sickle-cell disease with crisis. Accurate coding depends on the specific diagnosis and clinical presentation.