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ICD-10 Guide
ICD-10 CodesD59.10

D59.10

Billable

Autoimmune hemolytic anemia, unspecified

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

Code Description

ICD-10 D59.10 is a billable code used to indicate a diagnosis of autoimmune hemolytic anemia, unspecified.

Key Diagnostic Point:

Autoimmune hemolytic anemia (AIHA) is a condition characterized by the immune system mistakenly attacking and destroying red blood cells, leading to anemia. This condition can be classified into two main types: warm AIHA, where antibodies react at body temperature, and cold AIHA, where antibodies react at lower temperatures. The exact cause of AIHA can be idiopathic or secondary to other conditions such as infections, lymphoproliferative disorders, or autoimmune diseases like lupus. Patients may present with symptoms such as fatigue, pallor, jaundice, dark urine, and splenomegaly. Diagnosis typically involves laboratory tests including a complete blood count (CBC), reticulocyte count, direct Coombs test, and peripheral blood smear. Treatment options may include corticosteroids, immunosuppressive agents, or splenectomy, depending on the severity and underlying cause. The unspecified designation in this code indicates that the specific type of autoimmune hemolytic anemia has not been determined, which can complicate treatment and management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of underlying causes that can lead to AIHA.
  • Differentiation between warm and cold AIHA requires specific lab tests.
  • Potential overlap with other hemolytic anemias and conditions.
  • Need for comprehensive documentation to support the diagnosis.

Audit Risk Factors

  • Insufficient documentation of laboratory results.
  • Lack of clarity on the underlying cause of AIHA.
  • Inconsistent use of the unspecified code when a specific type is known.
  • Failure to document treatment plans and patient responses.

Specialty Focus

Medical Specialties

Hematology

Documentation Requirements

Detailed lab results, patient history, and treatment plans.

Common Clinical Scenarios

Diagnosis of AIHA in patients with autoimmune disorders or following infections.

Billing Considerations

Ensure clear documentation of the type of hemolytic anemia and any associated conditions.

Primary Care

Documentation Requirements

Comprehensive patient history and symptom documentation.

Common Clinical Scenarios

Initial evaluation of anemia symptoms leading to referral to hematology.

Billing Considerations

Documenting the rationale for referral and any preliminary lab findings.

Coding Guidelines

Inclusion Criteria

Use D59.10 When
  • Follow official coding guidelines for the use of D59
  • 10, ensuring that the unspecified nature of the diagnosis is justified by the clinical documentation
  • Include relevant lab results and patient history to support the diagnosis

Exclusion Criteria

Do NOT use D59.10 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

85025CPT Code

Complete blood count (CBC) with differential

Clinical Scenario

Used to evaluate anemia and monitor treatment response.

Documentation Requirements

Document the reason for the CBC and any relevant findings.

Specialty Considerations

Hematologists may require more detailed lab results.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of hemolytic anemias, improving the ability to capture the nuances of autoimmune hemolytic anemia. D59.10 serves as a catch-all for unspecified cases, which can impact treatment and management strategies.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of hemolytic anemias, improving the ability to capture the nuances of autoimmune hemolytic anemia. D59.10 serves as a catch-all for unspecified cases, which can impact treatment and management strategies.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of hemolytic anemias, improving the ability to capture the nuances of autoimmune hemolytic anemia. D59.10 serves as a catch-all for unspecified cases, which can impact treatment and management strategies.

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, while cold AIHA involves antibodies that react at lower temperatures, often leading to different clinical presentations and management strategies.