D56.5: Hemoglobin E-beta thalassemia
D56.5 is a billable, specific ICD-10-CM code for hemoglobin e-beta thalassemia. It is valid for submission on a claim.
Check D56.5 with the rest of the claim: free scrubberExcludes1: never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
Other codes that can never be billed with D56.5
Their own Excludes1 notes name this code, so the conflict is not listed above.
Risk adjustment
D56.5 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 108 Sickle Cell Disorders, Except Sickle Cell Anemia (Hb-SS) and Thalassemia Beta Zero; Beta Thalassemia Major0.146 RAF
Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score. Look up the whole chart to see which of its HCCs the hierarchy would zero.
Medicare coverage
D56.5 is named in 10 Medicare coverage policies: 10 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A55717Billing and Coding: Lab: Flow Cytometry
- A56464Billing and Coding: Flow Cytometry
- A56580Billing and Coding: Computerized Axial Tomography (CT), Thorax
- A56697Billing and Coding: Non-Invasive Vascular Studies
Alphabetic index entries that lead here
- Hemoglobin›E-beta thalassemia
- Disease, diseased›hemoglobin or Hb›E-beta thalassemia
- Thalassemia›hemoglobin›E-beta
Code history
Unchanged in every release from FY2024 to FY2027.