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ICD-10 Guide
ICD-10 CodesD57.458

D57.458

Billable

Sickle-cell thalassemia beta plus with crisis with other specified complication

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

Code Description

ICD-10 D57.458 is a billable code used to indicate a diagnosis of sickle-cell thalassemia beta plus with crisis with other specified complication.

Key Diagnostic Point:

Sickle-cell thalassemia beta plus is a complex hemoglobinopathy resulting from the combination of sickle cell disease and beta-thalassemia. Patients with this condition exhibit symptoms of both disorders, including chronic hemolytic anemia, vaso-occlusive crises, and potential complications such as infections and organ damage. The 'with crisis' designation indicates the presence of acute episodes characterized by severe pain due to vaso-occlusion, which can lead to further complications. The 'with other specified complication' aspect highlights that the patient may experience additional issues, such as acute chest syndrome, splenic sequestration, or stroke, which require careful monitoring and management. Genetic factors play a significant role in the pathophysiology of this condition, as it is inherited in an autosomal recessive manner. Understanding the interplay between sickle cell and thalassemia is crucial for effective treatment and management, as it influences the severity of symptoms and the risk of complications.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Combination of two genetic disorders complicates diagnosis and treatment.
  • Variability in clinical presentation and severity among patients.
  • Need for detailed documentation of crises and complications.
  • Potential for overlapping symptoms with other hemolytic anemias.

Audit Risk Factors

  • Inadequate documentation of crises and complications.
  • Failure to specify the type of thalassemia involved.
  • Misclassification of the condition as simple sickle cell disease.
  • Lack of genetic testing documentation.

Specialty Focus

Medical Specialties

Hematology

Documentation Requirements

Comprehensive documentation of patient history, genetic testing results, and detailed descriptions of crises and complications.

Common Clinical Scenarios

Management of acute pain crises, monitoring for acute chest syndrome, and treatment of infections.

Billing Considerations

Ensure accurate coding of complications and crises to reflect the severity of the patient's condition.

Genetics

Documentation Requirements

Documentation of family history, genetic testing results, and counseling notes.

Common Clinical Scenarios

Genetic counseling for families, interpretation of genetic tests, and management of hereditary conditions.

Billing Considerations

Highlight the importance of genetic factors in the patient's condition for accurate coding.

Coding Guidelines

Inclusion Criteria

Use D57.458 When
  • Follow official ICD
  • 10 coding guidelines, ensuring accurate documentation of the condition's complexity and any associated complications
  • Include specific details about the patient's clinical presentation and history to support the use of this code

Exclusion Criteria

Do NOT use D57.458 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 and complications.

Documentation Requirements

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

Specialty Considerations

Ensure that the specialty performing the procedure is noted.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of complex conditions like sickle-cell thalassemia beta plus, improving the accuracy of patient records and facilitating better management of care.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of complex conditions like sickle-cell thalassemia beta plus, improving the accuracy of patient records and facilitating better management of care.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of complex conditions like sickle-cell thalassemia beta plus, improving the accuracy of patient records and facilitating better management of care.

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 the 'with crisis' designation?

The 'with crisis' designation indicates that the patient is experiencing acute episodes of pain or other complications related to sickle-cell thalassemia beta plus, which requires immediate medical attention and management.