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ICD-10 Guide
ICD-10 CodesD59.30

D59.30

Billable

Hemolytic-uremic syndrome, unspecified

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

Code Description

ICD-10 D59.30 is a billable code used to indicate a diagnosis of hemolytic-uremic syndrome, unspecified.

Key Diagnostic Point:

Hemolytic-uremic syndrome (HUS) is a serious condition characterized by a triad of symptoms: hemolytic anemia, acute renal failure, and thrombocytopenia. It often follows an infection, particularly with certain strains of Escherichia coli, but can also arise from other causes such as genetic disorders, medications, or autoimmune diseases. The hemolytic component involves the destruction of red blood cells, leading to anemia, while the uremic aspect refers to the accumulation of waste products in the blood due to kidney failure. Patients may present with symptoms such as fatigue, pallor, decreased urine output, and abdominal pain. The unspecified designation indicates that the specific etiology of the hemolytic-uremic syndrome has not been determined, which can complicate treatment and management. Diagnosis typically involves laboratory tests to assess hemoglobin levels, platelet counts, and kidney function, as well as stool cultures to identify infectious agents. Understanding the underlying causes, including enzyme deficiencies, thalassemias, and genetic factors, is crucial for effective management and prevention of complications.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of potential underlying causes (infectious, genetic, autoimmune)
  • Need for comprehensive laboratory testing to confirm diagnosis
  • Differentiation from other hemolytic anemias and renal conditions
  • Potential for acute and chronic complications requiring ongoing management

Audit Risk Factors

  • Inadequate documentation of the underlying cause
  • Failure to specify acute vs. chronic conditions
  • Misclassification of HUS as a primary diagnosis without supporting evidence
  • Lack of detailed clinical notes regarding patient history and symptoms

Specialty Focus

Medical Specialties

Hematology

Documentation Requirements

Detailed patient history, laboratory results, and treatment plans must be documented.

Common Clinical Scenarios

Patients presenting with unexplained anemia, renal failure, and thrombocytopenia.

Billing Considerations

Ensure that all laboratory findings are clearly linked to the diagnosis of HUS.

Nephrology

Documentation Requirements

Comprehensive renal function assessments and treatment responses should be documented.

Common Clinical Scenarios

Patients with acute kidney injury following hemolytic events.

Billing Considerations

Document any interventions or dialysis treatments related to renal failure.

Coding Guidelines

Inclusion Criteria

Use D59.30 When
  • Follow official ICD
  • 10 coding guidelines, ensuring accurate documentation of the condition's etiology when known

Exclusion Criteria

Do NOT use D59.30 When
  • Exclude conditions that may mimic HUS but have distinct coding requirements

Related ICD-10 Codes

Related CPT Codes

85025CPT Code

Complete blood count (CBC) with differential

Clinical Scenario

Used to assess hemolytic anemia and thrombocytopenia in suspected HUS.

Documentation Requirements

Document the indication for the CBC and any relevant findings.

Specialty Considerations

Hematology specialists should ensure that all results are interpreted in the context of HUS.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of hemolytic-uremic syndrome, enabling better tracking of cases and outcomes. This specificity aids in research and quality improvement initiatives.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of hemolytic-uremic syndrome, enabling better tracking of cases and outcomes. This specificity aids in research and quality improvement initiatives.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of hemolytic-uremic syndrome, enabling better tracking of cases and outcomes. This specificity aids in research and quality improvement initiatives.

Resources

Clinical References

  • •
    CDC - Hemolytic Uremic Syndrome

Coding & Billing References

  • •
    CDC - Hemolytic Uremic Syndrome

Frequently Asked Questions

What are the common causes of hemolytic-uremic syndrome?

Common causes include infections (especially E. coli), genetic disorders, and certain medications. It can also occur following severe dehydration or as a complication of other diseases.