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ICD-10 Guide
ICD-10 CodesD59.31

D59.31

Billable

Infection-associated hemolytic-uremic syndrome

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

Code Description

ICD-10 D59.31 is a billable code used to indicate a diagnosis of infection-associated hemolytic-uremic syndrome.

Key Diagnostic Point:

Infection-associated hemolytic-uremic syndrome (HUS) is a serious condition characterized by the triad of hemolytic anemia, acute renal failure, and thrombocytopenia. It is often precipitated by infections, particularly those caused by Shiga toxin-producing Escherichia coli (STEC), which can lead to gastrointestinal symptoms such as diarrhea. The syndrome primarily affects children but can also occur in adults. The pathophysiology involves the binding of Shiga toxin to endothelial cells, leading to damage and subsequent activation of the coagulation cascade, resulting in microangiopathic hemolytic anemia and renal impairment. Clinicians must be vigilant in recognizing the signs and symptoms of HUS, as early intervention can significantly improve outcomes. Diagnosis typically involves laboratory tests showing low hemoglobin levels, elevated lactate dehydrogenase (LDH), low haptoglobin, and evidence of acute kidney injury. Management focuses on supportive care, including hydration and monitoring of renal function, while avoiding unnecessary use of antibiotics or antimotility agents, which may worsen the condition.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Requires understanding of hemolytic anemias and their causes.
  • Differentiation from other types of hemolytic syndromes.
  • Need for accurate documentation of infection history.
  • Potential overlap with other renal failure codes.

Audit Risk Factors

  • Inadequate documentation of infection history.
  • Failure to document laboratory findings supporting diagnosis.
  • Misclassification of hemolytic anemia types.
  • Inconsistent coding of acute renal failure.

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Detailed history of gastrointestinal symptoms, laboratory results, and renal function tests.

Common Clinical Scenarios

Children presenting with bloody diarrhea followed by signs of hemolytic anemia and renal failure.

Billing Considerations

Consideration of age-related factors and common pathogens in pediatric populations.

Nephrology

Documentation Requirements

Comprehensive renal function assessments and follow-up on hemolytic anemia.

Common Clinical Scenarios

Adults with acute renal failure and a history of recent infections.

Billing Considerations

Focus on renal implications and management strategies for acute kidney injury.

Coding Guidelines

Inclusion Criteria

Use D59.31 When
  • According to ICD
  • 10 coding guidelines, D59
  • 31 should be used when the hemolytic
  • uremic syndrome is specifically associated with an infectious process
  • Coders must ensure that the documentation supports the diagnosis and that any underlying conditions are also coded appropriately

Exclusion Criteria

Do NOT use D59.31 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

85025CPT Code

Complete blood count (CBC) with differential

Clinical Scenario

Used to assess hemolytic anemia in patients suspected of HUS.

Documentation Requirements

Document the reason for the CBC and any abnormal findings.

Specialty Considerations

Pediatricians should note age-specific reference ranges.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of conditions like infection-associated hemolytic-uremic syndrome, improving the accuracy of data collection and reimbursement processes. This specificity aids in better tracking of epidemiological trends and outcomes related to HUS.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like infection-associated hemolytic-uremic syndrome, improving the accuracy of data collection and reimbursement processes. This specificity aids in better tracking of epidemiological trends and outcomes related to HUS.

Reimbursement & Billing Impact

reimbursement processes. This specificity aids in better tracking of epidemiological trends and outcomes related to HUS.

Resources

Clinical References

  • •
    CDC - Hemolytic Uremic Syndrome

Coding & Billing References

  • •
    CDC - Hemolytic Uremic Syndrome

Frequently Asked Questions

What are the common causes of infection-associated hemolytic-uremic syndrome?

The most common cause is infection with Shiga toxin-producing E. coli (STEC), particularly serotype O157:H7. Other infectious agents can also lead to HUS, but STEC is the most frequently identified.