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ICD-10 Guide
ICD-10 CodesD57.213

D57.213

Billable

Sickle-cell/Hb-C disease with cerebral vascular involvement

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

Code Description

ICD-10 D57.213 is a billable code used to indicate a diagnosis of sickle-cell/hb-c disease with cerebral vascular involvement.

Key Diagnostic Point:

Sickle-cell/Hb-C disease with cerebral vascular involvement is a complex hemolytic anemia characterized by the presence of both sickle hemoglobin (HbS) and hemoglobin C (HbC). This condition arises from genetic mutations in the HBB gene, leading to abnormal hemoglobin production. Patients with this disease often experience vaso-occlusive crises, hemolytic anemia, and increased risk of stroke due to cerebral vascular involvement. The sickling of red blood cells can obstruct blood flow in small vessels, resulting in ischemia and potential neurological deficits. Clinical manifestations may include recurrent pain episodes, fatigue, and complications such as acute chest syndrome and stroke. Management typically involves pain control, hydration, and preventive measures against infections and stroke. Regular monitoring and comprehensive care are essential to mitigate complications and improve quality of life.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Requires understanding of genetic factors and hemoglobinopathies.
  • Involves knowledge of associated complications like stroke.
  • Differentiation from other types of sickle cell diseases.
  • Documentation must specify cerebral vascular involvement.

Audit Risk Factors

  • Inadequate documentation of cerebral vascular events.
  • Misclassification of sickle cell disease types.
  • Failure to document associated complications.
  • Inconsistent coding of hemolytic anemia.

Specialty Focus

Medical Specialties

Hematology

Documentation Requirements

Detailed patient history, lab results showing hemoglobin types, and evidence of complications.

Common Clinical Scenarios

Management of pain crises, monitoring for stroke, and treatment of infections.

Billing Considerations

Ensure documentation reflects the severity of anemia and any neurological assessments.

Neurology

Documentation Requirements

Neurological evaluations, imaging studies (e.g., MRI), and detailed descriptions of symptoms.

Common Clinical Scenarios

Evaluation of stroke symptoms in patients with sickle cell disease.

Billing Considerations

Document the relationship between sickle cell disease and neurological findings.

Coding Guidelines

Inclusion Criteria

Use D57.213 When
  • Follow ICD
  • CM guidelines for coding hemolytic anemias and ensure accurate documentation of cerebral vascular involvement
  • Include relevant clinical findings and laboratory results

Exclusion Criteria

Do NOT use D57.213 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 to monitor hemoglobin levels.

Documentation Requirements

Document the reason for blood draw and any relevant clinical findings.

Specialty Considerations

Hematology specialists should ensure comprehensive lab results are included.

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 patient records and facilitating better management of complications.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of sickle cell diseases, improving the accuracy of patient records and facilitating better management of complications.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of sickle cell diseases, improving the accuracy of patient records and facilitating better management of complications.

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 D57.213?

Coding D57.213 accurately reflects the complexity of sickle-cell/Hb-C disease with cerebral vascular involvement, ensuring appropriate management and reimbursement for the care provided.