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ICD-10 Guide
ICD-10 CodesD57.20

D57.20

Billable

Sickle-cell/Hb-C disease without crisis

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

Code Description

ICD-10 D57.20 is a billable code used to indicate a diagnosis of sickle-cell/hb-c disease without crisis.

Key Diagnostic Point:

Sickle-cell/Hb-C disease without crisis refers to a genetic blood disorder characterized by the presence of abnormal hemoglobin, specifically hemoglobin C, which can lead to hemolytic anemia. This condition arises from mutations in the HBB gene that encodes the beta-globin subunit of hemoglobin. Patients with Hb-C disease may experience chronic hemolytic anemia, splenomegaly, and increased susceptibility to infections. Unlike sickle cell crises, which involve acute pain episodes due to vaso-occlusive events, this code is used when the patient is not experiencing such crises. Management typically includes regular monitoring of hemoglobin levels, supportive care, and preventive measures against infections. Genetic counseling is often recommended for affected individuals and their families to understand inheritance patterns and implications for offspring. The clinical presentation can vary widely, and some patients may remain asymptomatic for extended periods, while others may have significant complications related to anemia and organ function.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between sickle cell disease and Hb-C disease
  • Understanding the genetic basis and inheritance patterns
  • Identifying associated complications and comorbidities
  • Navigating documentation requirements for chronic conditions

Audit Risk Factors

  • Inadequate documentation of hemoglobin levels
  • Failure to document the absence of crisis
  • Misclassification of sickle cell disease types
  • Lack of genetic testing results in the medical record

Specialty Focus

Medical Specialties

Hematology

Documentation Requirements

Detailed lab results, genetic testing, and treatment plans.

Common Clinical Scenarios

Management of chronic anemia, monitoring for complications.

Billing Considerations

Ensure documentation reflects the absence of crisis and any related comorbidities.

Genetics

Documentation Requirements

Family history, genetic counseling notes, and test results.

Common Clinical Scenarios

Counseling patients about inheritance patterns and implications for family members.

Billing Considerations

Document genetic testing outcomes and recommendations for family screening.

Coding Guidelines

Inclusion Criteria

Use D57.20 When
  • Follow ICD
  • CM guidelines for coding genetic disorders and hemolytic anemias
  • Ensure accurate documentation of the patient's clinical status, including the absence of crisis, and any relevant lab results

Exclusion Criteria

Do NOT use D57.20 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

85025CPT Code

Complete blood count (CBC) with differential

Clinical Scenario

Used to monitor hemoglobin levels and anemia status in patients with Hb-C disease.

Documentation Requirements

Document the reason for the CBC and any relevant clinical findings.

Specialty Considerations

Hematologists should ensure that all lab results are clearly linked to the diagnosis.

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 disorders, improving the accuracy of data collection and reimbursement processes. D57.20 provides a clear distinction from other related conditions, enhancing clinical understanding and management.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of sickle cell disorders, improving the accuracy of data collection and reimbursement processes. D57.20 provides a clear distinction from other related conditions, enhancing clinical understanding and management.

Reimbursement & Billing Impact

reimbursement processes. D57.20 provides a clear distinction from other related conditions, enhancing clinical understanding and management.

Resources

Clinical References

  • •
    CDC Sickle Cell Disease Resources

Coding & Billing References

  • •
    CDC Sickle Cell Disease Resources

Frequently Asked Questions

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

Sickle cell disease is characterized by the presence of hemoglobin S, while Hb-C disease involves hemoglobin C. Both conditions can lead to hemolytic anemia, but their genetic causes and clinical manifestations differ.