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ICD-10 Guide
ICD-10 CodesD57.00

D57.00

Billable

Hb-SS disease with crisis, unspecified

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

Code Description

ICD-10 D57.00 is a billable code used to indicate a diagnosis of hb-ss disease with crisis, unspecified.

Key Diagnostic Point:

Hb-SS disease, commonly known as sickle cell disease, is a genetic blood disorder characterized by the production of abnormal hemoglobin, known as hemoglobin S (HbS). This condition leads to the distortion of red blood cells into a sickle or crescent shape, which can cause blockages in blood vessels, leading to pain crises and other complications. Patients with Hb-SS disease often experience episodes of severe pain, known as sickle cell crises, due to vaso-occlusive events. These crises can be triggered by various factors, including dehydration, infection, and extreme temperatures. 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. The clinical management of Hb-SS disease includes pain management, hydration, and preventive measures against infections. Regular monitoring and comprehensive care are essential to manage complications such as acute chest syndrome, stroke, and organ damage. The unspecified crisis designation indicates that the specific type of crisis (e.g., vaso-occlusive, acute chest syndrome) has not been documented, which may affect treatment and management strategies.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation and severity of crises
  • Need for precise documentation of crisis type
  • Potential for co-morbid conditions affecting coding
  • Differentiation from other hemolytic anemias and sickle cell variants

Audit Risk Factors

  • Inadequate documentation of crisis type
  • Failure to document patient history and genetic factors
  • Misclassification of sickle cell disease severity
  • Inconsistent coding of related complications

Specialty Focus

Medical Specialties

Hematology

Documentation Requirements

Detailed patient history, including family history of sickle cell disease, frequency and type of crises, and treatment plans.

Common Clinical Scenarios

Management of pain crises, acute chest syndrome, and chronic complications of sickle cell disease.

Billing Considerations

Ensure accurate documentation of crisis type and associated complications to support coding.

Pediatrics

Documentation Requirements

Growth and development assessments, vaccination history, and management of complications in pediatric patients.

Common Clinical Scenarios

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

Billing Considerations

Consider age-specific guidelines and the impact of sickle cell disease on development.

Coding Guidelines

Inclusion Criteria

Use D57.00 When
  • Follow official coding guidelines for sickle cell disease, ensuring accurate documentation of the patient's clinical status and any associated complications
  • Include relevant family history and genetic testing results when applicable

Exclusion Criteria

Do NOT use D57.00 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

36415CPT Code

Collection of venous blood by venipuncture

Clinical Scenario

Used for routine blood tests in patients with sickle cell disease.

Documentation Requirements

Document the reason for blood collection and any relevant patient history.

Specialty Considerations

Ensure that the procedure is linked to the diagnosis of Hb-SS disease.

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 disease and its complications, improving the accuracy of data collection and reimbursement processes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of sickle cell disease and its complications, improving the accuracy of data collection and reimbursement processes.

Reimbursement & Billing Impact

reimbursement processes.

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 the presence of two copies of the sickle cell gene, leading to significant health complications. In contrast, sickle cell trait occurs when an individual has one copy of the sickle cell gene and one normal gene, typically resulting in no symptoms or complications.