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.

Check D57.04 with the rest of the claim: free scrubber

Excludes1 inherited from the categories above D57.04

A category’s note binds every code beneath it.

Written on D57: Sickle-cell disorders

other hemoglobinopathies (D58.-)

Other codes that can never be billed with D57.04

Their own Excludes1 notes name this code, so the conflict is not listed above.

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. Look up the whole chart to see which of its HCCs the hierarchy would zero.

Medicare coverage

D57.04 is named in 20 Medicare coverage policies: 20 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

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

Alphabetic index entries that lead here

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

Unchanged in every release from FY2024 to FY2027.