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v1.0.0
ICD-10 Guide
ICD-10 CodesD59.19

D59.19

Billable

Other autoimmune hemolytic anemia

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

Code Description

ICD-10 D59.19 is a billable code used to indicate a diagnosis of other autoimmune hemolytic anemia.

Key Diagnostic Point:

Other autoimmune hemolytic anemia (AIHA) refers to a group of disorders characterized by the immune system mistakenly attacking and destroying red blood cells, leading to hemolytic anemia. This condition can be classified into warm and cold AIHA, depending on the temperature at which the antibodies react with red blood cells. Patients may present with symptoms such as fatigue, pallor, jaundice, and splenomegaly. The etiology of AIHA can be idiopathic or secondary to other conditions, including infections, malignancies, or autoimmune diseases. Diagnosis typically involves laboratory tests such as a complete blood count (CBC), reticulocyte count, direct Coombs test, and peripheral blood smear. Treatment options may include corticosteroids, immunosuppressive agents, or splenectomy, depending on the severity and underlying cause. Understanding the nuances of AIHA is crucial for accurate coding and management, as it can overlap with other hemolytic anemias, enzyme deficiencies, and genetic disorders like thalassemias and sickle cell disease.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiation from other types of hemolytic anemia
  • Need for comprehensive patient history to identify underlying causes
  • Variability in clinical presentation and laboratory findings
  • Potential overlap with other autoimmune conditions

Audit Risk Factors

  • Inadequate documentation of clinical findings
  • Failure to specify the type of autoimmune hemolytic anemia
  • Lack of supporting lab results for diagnosis
  • Misclassification with other hemolytic anemias

Specialty Focus

Medical Specialties

Hematology

Documentation Requirements

Detailed lab results, patient history, and treatment plans.

Common Clinical Scenarios

Diagnosis and management of AIHA, monitoring treatment response.

Billing Considerations

Ensure clarity in distinguishing AIHA from other hemolytic anemias.

Rheumatology

Documentation Requirements

Comprehensive autoimmune disease history and related lab tests.

Common Clinical Scenarios

AIHA as a secondary condition to autoimmune disorders.

Billing Considerations

Document any associated autoimmune conditions that may influence treatment.

Coding Guidelines

Inclusion Criteria

Use D59.19 When
  • Follow the official ICD
  • CM coding guidelines for specificity in coding autoimmune hemolytic anemia
  • Ensure to document the type of AIHA and any underlying conditions that may contribute to the diagnosis

Exclusion Criteria

Do NOT use D59.19 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

85025CPT Code

Complete blood count (CBC) with automated differential

Clinical Scenario

Used to evaluate anemia and monitor treatment response.

Documentation Requirements

Document the reason for the CBC and any relevant clinical findings.

Specialty Considerations

Hematologists may require additional tests to assess hemolysis.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of autoimmune hemolytic anemias, improving the accuracy of diagnoses and treatment tracking. This specificity aids in better patient management and resource allocation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of autoimmune hemolytic anemias, improving the accuracy of diagnoses and treatment tracking. This specificity aids in better patient management and resource allocation.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of autoimmune hemolytic anemias, improving the accuracy of diagnoses and treatment tracking. This specificity aids in better patient management and resource allocation.

Resources

Clinical References

  • •
    American Society of Hematology

Coding & Billing References

  • •
    American Society of Hematology

Frequently Asked Questions

What is the difference between warm and cold AIHA?

Warm AIHA occurs when antibodies react at body temperature, leading to hemolysis, while cold AIHA occurs when antibodies react at lower temperatures, often causing hemolysis in peripheral areas of the body.