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ICD-10 Guide
ICD-10 CodesD57.02

D57.02

Billable

Hb-SS disease with splenic sequestration

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

Code Description

ICD-10 D57.02 is a billable code used to indicate a diagnosis of hb-ss disease with splenic sequestration.

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 patients with Hb-SS disease, the red blood cells become rigid and sickle-shaped, leading to various complications, including hemolytic anemia, pain crises, and organ damage. Splenic sequestration occurs when sickled red blood cells obstruct blood flow in the spleen, causing acute splenic enlargement and a sudden drop in hemoglobin levels. This condition can lead to severe anemia and requires prompt medical intervention. Patients may present with symptoms such as abdominal pain, pallor, fatigue, and signs of shock. The management of splenic sequestration often involves hydration, pain management, and sometimes blood transfusions. Genetic factors play a crucial role in the disease, as it is inherited in an autosomal recessive pattern. Understanding the pathophysiology of Hb-SS disease and its complications is essential for effective treatment and coding.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Requires understanding of genetic inheritance patterns.
  • Differentiation from other types of sickle cell disease.
  • Need for accurate documentation of splenic sequestration events.
  • Potential for co-morbid conditions that may complicate coding.

Audit Risk Factors

  • Inadequate documentation of splenic sequestration episodes.
  • Failure to document the severity of anemia.
  • Misclassification of sickle cell disease types.
  • Lack of supporting lab results for hemoglobin levels.

Specialty Focus

Medical Specialties

Hematology

Documentation Requirements

Detailed clinical notes on hemoglobin levels, splenic size, and patient history.

Common Clinical Scenarios

Management of acute splenic sequestration, chronic pain management, and transfusion therapy.

Billing Considerations

Ensure comprehensive documentation of all episodes of splenic sequestration and related treatments.

Pediatrics

Documentation Requirements

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

Common Clinical Scenarios

Routine check-ups for children with Hb-SS disease, management of pain crises.

Billing Considerations

Monitor for developmental delays and ensure family education on disease management.

Coding Guidelines

Inclusion Criteria

Use D57.02 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate documentation of the condition and any associated complications
  • Include relevant lab results and clinical findings to support the diagnosis

Exclusion Criteria

Do NOT use D57.02 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

36430CPT Code

Transfusion, blood or blood components

Clinical Scenario

Used during acute management of splenic sequestration.

Documentation Requirements

Document the reason for transfusion and patient response.

Specialty Considerations

Hematology specialists should ensure that transfusion protocols are followed.

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, including the differentiation of splenic sequestration, which enhances the accuracy of patient records and treatment plans.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of sickle cell diseases, including the differentiation of splenic sequestration, which enhances the accuracy of patient records and treatment plans.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of sickle cell diseases, including the differentiation of splenic sequestration, which enhances the accuracy of patient records and treatment plans.

Resources

Clinical References

  • •
    Sickle Cell Disease Association of America

Coding & Billing References

  • •
    Sickle Cell Disease Association of America

Frequently Asked Questions

What is the significance of coding D57.02?

Coding D57.02 accurately reflects the patient's condition of Hb-SS disease with splenic sequestration, which is critical for appropriate treatment, management, and reimbursement.