Is D57.04 a billable ICD-10-CM code?

Yes. D57.04 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does D57.04 sit in the tabular list?

Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism (D50-D89), in the block Hemolytic anemias (D55-D59).

What cannot be coded together with D57.04?

D57.04 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above D57.04 (D57) and apply to it just the same.

D57.04

D57.04 — Hb-SS disease with dactylitis

Billable / specific codeICD-10-CM

D57.04 is a billable, specific ICD-10-CM code for hb-ss disease with dactylitis. It is valid for submission on a claim.

Excludes1 inherited from the categories above D57.04

These are not written on D57.04, but they bind it: a note on a category applies to every code beneath it. Billing D57.04 with anything listed here is a denial.

Written on D57 — Sickle-cell disorders

other hemoglobinopathies (D58.-)

Other codes that can never be billed with D57.04

These codes carry an Excludes1 note pointing at D57.04. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading D57.04 alone.

D56.8Other thalassemias

Risk adjustment

D57.04 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:

HCC 107 Sickle Cell Anemia (Hb-SS) and Thalassemia Beta Zero0.457 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.

Medicare coverage

D57.04 is named in 20 Medicare coverage policies — 20 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A53060Billing and Coding: Ophthalmology: Extended Ophthalmoscopy and Fundus Photography
A55717Billing and Coding: Lab: Flow Cytometry
A56421Billing and Coding: CT of the Abdomen and Pelvis
A56580Billing and Coding: Computerized Axial Tomography (CT), Thorax

How D57.04 is indexed

Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to D57.04.

Dactylitis›sickle-cell
Dactylitis›sickle-cell›Hb SS
Disease, diseased›sickle-cell›with›dactylitis
Disease, diseased›sickle-cell›with›crisis›with›dactylitis
Disease, diseased›hemoglobin or Hb›S or SS›with›crisis›with›dactylitis

Code history

D57.04 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Related codes at this level

Codes that share D57.0. If D57.04 is not quite right, the correct code is usually one of these.

Questions about D57.04

Is D57.04 a billable ICD-10-CM code?: Yes. D57.04 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does D57.04 sit in the tabular list?: Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism (D50-D89), in the block Hemolytic anemias (D55-D59).
What cannot be coded together with D57.04?: D57.04 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above D57.04 (D57) and apply to it just the same.