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ICD-10 Guide
ICD-10 CodesD57.0

D57.0

Billable

Hb-SS disease with crisis

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

Code Description

ICD-10 D57.0 is a billable code used to indicate a diagnosis of hb-ss disease with crisis.

Key Diagnostic Point:

Hb-SS disease, commonly known as sickle cell disease, is a genetic blood disorder characterized by the presence of hemoglobin S (HbS) in red blood cells. This condition leads to the distortion of red blood cells into a sickle shape, particularly under low oxygen conditions. Patients with Hb-SS disease experience recurrent painful episodes known as sickle cell crises, which occur due to vaso-occlusion caused by the sickled cells obstructing blood flow in small vessels. These crises can lead to acute pain, organ damage, and increased risk of infections. The disease is inherited in an autosomal recessive pattern, meaning that both parents must carry the sickle cell trait for a child to be affected. Management of Hb-SS disease includes pain management, hydration, blood transfusions, and hydroxyurea therapy to reduce the frequency of crises. Regular monitoring and preventive care are essential to manage complications such as acute chest syndrome, stroke, and organ dysfunction.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation and severity of crises
  • Need for detailed documentation of crisis episodes
  • Potential for co-morbid conditions complicating the diagnosis
  • Differentiation from other types of sickle cell disease and hemolytic anemias

Audit Risk Factors

  • Inadequate documentation of crisis episodes
  • Failure to document the severity and duration of pain
  • Lack of evidence for supportive treatments provided
  • Misclassification of the type of sickle cell disease

Specialty Focus

Medical Specialties

Hematology

Documentation Requirements

Detailed clinical notes on patient history, frequency of crises, and treatment plans.

Common Clinical Scenarios

Management of acute pain crises, blood transfusion therapy, and monitoring for complications.

Billing Considerations

Ensure accurate documentation of laboratory results, including hemoglobin electrophoresis.

Pediatrics

Documentation Requirements

Growth and development assessments, vaccination status, and family history of sickle cell disease.

Common Clinical Scenarios

Routine check-ups, management of pain crises, and preventive care.

Billing Considerations

Documenting parental education on disease management and crisis prevention.

Coding Guidelines

Inclusion Criteria

Use D57.0 When
  • According to ICD
  • 10 guidelines, D57
  • 0 should be used when the patient has Hb
  • SS disease with an acute crisis
  • Documentation must support the diagnosis and specify the nature of the crisis

Exclusion Criteria

Do NOT use D57.0 When
  • Exclusions include other types of sickle cell disease without crisis

Related ICD-10 Codes

Related CPT Codes

36430CPT Code

Transfusion, blood or blood components

Clinical Scenario

Used during acute crises requiring blood transfusion.

Documentation Requirements

Document the reason for transfusion, type of blood product, 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 diseases, improving the accuracy of data collection and reimbursement processes. D57.0 provides a clear distinction for Hb-SS disease with crisis, facilitating better patient management and research.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of sickle cell diseases, improving the accuracy of data collection and reimbursement processes. D57.0 provides a clear distinction for Hb-SS disease with crisis, facilitating better patient management and research.

Reimbursement & Billing Impact

reimbursement processes. D57.0 provides a clear distinction for Hb-SS disease with crisis, facilitating better patient management and research.

Resources

Clinical References

  • •
    Sickle Cell Disease Association of America

Coding & Billing References

  • •
    Sickle Cell Disease Association of America

Frequently Asked Questions

What is the difference between Hb-SS disease and sickle cell trait?

Hb-SS disease is a severe form of sickle cell disease characterized by significant health complications, while sickle cell trait is a carrier state that typically does not cause symptoms or health issues.