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v1.0.0
ICD-10 Guide
ICD-10 CodesD59.1

D59.1

Billable

Other autoimmune hemolytic anemias

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

Code Description

ICD-10 D59.1 is a billable code used to indicate a diagnosis of other autoimmune hemolytic anemias.

Key Diagnostic Point:

Other autoimmune hemolytic anemias (AIHA) represent a group of disorders characterized by the immune system mistakenly attacking and destroying red blood cells, leading to anemia. This condition can be classified into warm and cold AIHA, depending on the temperature at which the antibodies react. Warm AIHA is often associated with conditions such as lymphoproliferative disorders, autoimmune diseases, and certain infections, while cold AIHA is typically linked to cold agglutinin disease and infections like Mycoplasma pneumoniae. Patients may present with symptoms such as fatigue, pallor, jaundice, and splenomegaly. Diagnosis is confirmed through laboratory tests, including a complete blood count (CBC), reticulocyte count, direct Coombs test, and peripheral blood smear. Treatment options vary based on the underlying cause and severity of the anemia, ranging from corticosteroids and immunosuppressive therapies to splenectomy and blood transfusions. Understanding the nuances of AIHA is crucial for accurate coding and effective patient management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of underlying causes leading to AIHA.
  • Differentiation between warm and cold AIHA.
  • Potential overlap with other hemolytic anemias.
  • Need for comprehensive laboratory documentation.

Audit Risk Factors

  • Inadequate documentation of laboratory results.
  • Failure to specify the type of autoimmune hemolytic anemia.
  • Lack of clarity on the underlying cause.
  • Inconsistent coding of related conditions.

Specialty Focus

Medical Specialties

Hematology

Documentation Requirements

Detailed lab results, including CBC, reticulocyte count, and Coombs test results.

Common Clinical Scenarios

Diagnosis and management of AIHA, monitoring treatment response.

Billing Considerations

Ensure accurate documentation of the type of AIHA and any associated conditions.

Internal Medicine

Documentation Requirements

Comprehensive patient history, physical examination findings, and treatment plans.

Common Clinical Scenarios

Evaluation of anemia in patients with autoimmune disorders.

Billing Considerations

Documenting the patient's overall health status and any comorbidities.

Coding Guidelines

Inclusion Criteria

Use D59.1 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate documentation of the type of autoimmune hemolytic anemia and any underlying conditions
  • Include relevant lab results and clinical findings to support the diagnosis

Exclusion Criteria

Do NOT use D59.1 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

85025CPT Code

Complete blood count with reticulocyte count

Clinical Scenario

Used to evaluate anemia and monitor treatment response.

Documentation Requirements

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

Specialty Considerations

Hematology specialists should ensure comprehensive lab documentation.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of autoimmune hemolytic anemias, improving the accuracy of data collection and reimbursement processes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of autoimmune hemolytic anemias, improving the accuracy of data collection and reimbursement processes.

Reimbursement & Billing Impact

reimbursement processes.

Resources

Clinical References

  • •
    American Society of Hematology

Coding & Billing References

  • •
    American Society of Hematology

Frequently Asked Questions

What is the difference between warm and cold AIHA?

Warm AIHA involves antibodies that react at body temperature, often associated with autoimmune diseases, while cold AIHA involves antibodies that react at lower temperatures, typically linked to infections or certain malignancies.