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ICD-10 Guide
ICD-10 CodesD57.812

D57.812

Billable

Other sickle-cell disorders with splenic sequestration

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

Code Description

ICD-10 D57.812 is a billable code used to indicate a diagnosis of other sickle-cell disorders with splenic sequestration.

Key Diagnostic Point:

D57.812 refers to a specific type of sickle-cell disorder characterized by splenic sequestration, a serious complication where sickle-shaped red blood cells become trapped in the spleen, leading to acute splenic enlargement and a sudden drop in hemoglobin levels. This condition is particularly prevalent in children with sickle cell disease and can result in severe anemia, pain, and potential life-threatening complications. The pathophysiology involves the abnormal shape of red blood cells, which can obstruct blood flow in the spleen, causing congestion and splenic infarction. Patients may present with symptoms such as abdominal pain, pallor, fatigue, and signs of shock in severe cases. Management typically includes hydration, pain control, and sometimes blood transfusions to alleviate anemia. Understanding the genetic basis of sickle cell disease, which is caused by a mutation in the HBB gene on chromosome 11, is crucial for diagnosis and treatment. This code is essential for capturing the complexity of sickle-cell disorders and their complications in clinical documentation and billing.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Requires understanding of genetic factors related to sickle cell disease.
  • Involves knowledge of acute complications like splenic sequestration.
  • Differentiation from other hemolytic anemias and sickle cell variants.
  • Need for precise documentation of clinical symptoms and management.

Audit Risk Factors

  • Inadequate documentation of splenic sequestration events.
  • Failure to document the severity of anemia.
  • Misclassification of sickle cell types.
  • Lack of evidence for acute management interventions.

Specialty Focus

Medical Specialties

Hematology

Documentation Requirements

Detailed clinical notes on hemoglobin levels, splenic size, and management strategies.

Common Clinical Scenarios

Patients presenting with acute splenic sequestration crisis, chronic pain management, and transfusion therapy.

Billing Considerations

Ensure accurate coding of complications and comorbidities related to sickle cell disease.

Pediatrics

Documentation Requirements

Growth charts, developmental assessments, and family history of sickle cell disease.

Common Clinical Scenarios

Children with recurrent pain crises, splenic sequestration episodes, and routine health maintenance.

Billing Considerations

Focus on age-specific manifestations and management strategies for pediatric patients.

Coding Guidelines

Inclusion Criteria

Use D57.812 When
  • Follow ICD
  • CM guidelines for coding sickle cell disorders, ensuring accurate documentation of the acute nature of splenic sequestration
  • Include relevant clinical details such as hemoglobin levels and treatment interventions

Exclusion Criteria

Do NOT use D57.812 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

36430CPT Code

Transfusion, blood or blood components

Clinical Scenario

Used during acute management of splenic sequestration.

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 disorders, including complications like splenic sequestration. This specificity enhances the ability to track and manage patient outcomes effectively.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of sickle cell disorders, including complications like splenic sequestration. This specificity enhances the ability to track and manage patient outcomes effectively.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of sickle cell disorders, including complications like splenic sequestration. This specificity enhances the ability to track and manage patient outcomes effectively.

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 D57.812?

Coding D57.812 accurately captures the complexity of sickle cell disorders with splenic sequestration, ensuring appropriate management and reimbursement for the care provided.