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ICD-10 Guide
ICD-10 CodesD57.21

D57.21

Billable

Sickle-cell/Hb-C disease with crisis

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

Code Description

ICD-10 D57.21 is a billable code used to indicate a diagnosis of sickle-cell/hb-c disease with crisis.

Key Diagnostic Point:

Sickle-cell/Hb-C disease with crisis refers to a specific type of hemolytic anemia characterized by the presence of both sickle hemoglobin (HbS) and hemoglobin C (HbC). This condition arises from genetic mutations affecting the beta-globin gene, leading to the production of abnormal hemoglobin. Patients with this disease experience recurrent painful crises due to vaso-occlusive events, where sickle-shaped red blood cells obstruct blood flow in small vessels. This can result in acute pain episodes, organ damage, and increased risk of infections. The crisis can be triggered by various factors, including dehydration, infection, and extreme temperatures. Management typically involves pain control, hydration, and sometimes blood transfusions. Understanding the genetic basis of this condition is crucial, as it is inherited in an autosomal recessive pattern, meaning that both parents must carry the gene for a child to be affected. Regular monitoring and preventive care are essential to manage complications and improve quality of life for affected individuals.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Requires understanding of genetic factors and inheritance patterns.
  • Differentiation from other hemolytic anemias and thalassemias.
  • Need for accurate documentation of crisis episodes.
  • Potential for co-morbid conditions complicating the diagnosis.

Audit Risk Factors

  • Inadequate documentation of crisis episodes.
  • Misclassification with other types of sickle cell disease.
  • Failure to document genetic testing results.
  • Lack of comprehensive patient history regarding hemolytic events.

Specialty Focus

Medical Specialties

Hematology

Documentation Requirements

Detailed patient history, genetic testing results, and documentation of crisis episodes.

Common Clinical Scenarios

Management of pain crises, blood transfusions, and monitoring for complications.

Billing Considerations

Ensure accurate documentation of the type of hemoglobinopathy and associated symptoms.

Pediatrics

Documentation Requirements

Growth and development assessments, family history of hemoglobinopathies, and vaccination status.

Common Clinical Scenarios

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

Billing Considerations

Consider age-related factors in symptom presentation and management.

Coding Guidelines

Inclusion Criteria

Use D57.21 When
  • Follow official ICD
  • CM coding guidelines, ensuring accurate documentation of the condition's severity and any associated complications
  • Include specific details about the crisis episodes and any relevant laboratory findings

Exclusion Criteria

Do NOT use D57.21 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

36430CPT Code

Transfusion, blood or blood components

Clinical Scenario

Used during management of severe anemia or crisis.

Documentation Requirements

Document the reason for transfusion 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 hemoglobinopathies, improving the accuracy of data collection and reimbursement processes. D57.21 provides a clear distinction between types of sickle cell disease, facilitating better patient management and research.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of hemoglobinopathies, improving the accuracy of data collection and reimbursement processes. D57.21 provides a clear distinction between types of sickle cell disease, facilitating better patient management and research.

Reimbursement & Billing Impact

reimbursement processes. D57.21 provides a clear distinction between types of sickle cell disease, 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 D57.21 and D57.22?

D57.21 indicates sickle-cell/Hb-C disease with crisis, while D57.22 refers to the same disease without crisis. Accurate documentation of crisis episodes is essential for correct coding.