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ICD-10 Guide
ICD-10 CodesChapter 3: Diseases of the blood and blood-forming organsD59

D59

Billable

Acquired hemolytic anemia

Chapter 3:Diseases of the blood and blood-forming organs

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

Code Description

ICD-10 D59 is a billable code used to indicate a diagnosis of acquired hemolytic anemia.

Key Diagnostic Point:

Acquired hemolytic anemia (D59) refers to a group of conditions characterized by the premature destruction of red blood cells (RBCs) leading to anemia. This condition can arise from various factors, including autoimmune disorders, infections, certain medications, and exposure to toxins. Unlike hereditary forms of hemolytic anemia, acquired hemolytic anemia is not inherited but develops due to external factors. The destruction of RBCs can occur intravascularly (within blood vessels) or extravascularly (primarily in the spleen or liver). Symptoms may include fatigue, pallor, jaundice, dark urine, and splenomegaly. Diagnosis typically involves a combination of clinical evaluation, laboratory tests such as a complete blood count (CBC), reticulocyte count, and specific tests for hemolysis (e.g., haptoglobin, lactate dehydrogenase). Treatment focuses on addressing the underlying cause, which may involve immunosuppressive therapy, corticosteroids, or transfusions in severe cases. Understanding the etiology and pathophysiology of acquired hemolytic anemia is crucial for effective management and coding.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of underlying causes requiring thorough documentation.
  • Differentiation from hereditary hemolytic anemias.
  • Potential for overlapping symptoms with other anemias.
  • Need for specific laboratory test results to support diagnosis.

Audit Risk Factors

  • Inadequate documentation of the underlying cause.
  • Failure to specify the type of acquired hemolytic anemia.
  • Misclassification with hereditary forms of anemia.
  • Lack of supporting laboratory results.

Specialty Focus

Medical Specialties

Hematology

Documentation Requirements

Detailed clinical history, laboratory results, and treatment plans.

Common Clinical Scenarios

Patients presenting with fatigue, jaundice, and elevated reticulocyte counts.

Billing Considerations

Ensure clear documentation of hemolytic processes and any autoimmune components.

Internal Medicine

Documentation Requirements

Comprehensive patient history and physical examination findings.

Common Clinical Scenarios

Patients with unexplained anemia and signs of hemolysis.

Billing Considerations

Document any medications or infections that may contribute to hemolysis.

Coding Guidelines

Inclusion Criteria

Use D59 When
  • According to ICD
  • 10 guidelines, D59 should be used when the hemolytic anemia is acquired and not due to genetic factors
  • Coders must ensure that the underlying cause is documented and that the condition is not a result of a hereditary disorder

Exclusion Criteria

Do NOT use D59 When
No specific exclusions found.

Related CPT Codes

85025CPT Code

Complete blood count with reticulocyte count

Clinical Scenario

Used to evaluate anemia and hemolysis.

Documentation Requirements

Document the reason for the test and results.

Specialty Considerations

Hematologists may require more detailed lab interpretations.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of acquired hemolytic anemia, improving the ability to capture the nuances of the condition and its causes, which aids in better patient management and research.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of acquired hemolytic anemia, improving the ability to capture the nuances of the condition and its causes, which aids in better patient management and research.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of acquired hemolytic anemia, improving the ability to capture the nuances of the condition and its causes, which aids in better patient management and research.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What are the common causes of acquired hemolytic anemia?

Common causes include autoimmune disorders, infections, certain medications, and exposure to toxins. Each cause may require different management strategies.