D57.212
D57.212: Sickle-cell/Hb-C disease with splenic sequestration
Billable / specific codeICD-10-CM
D57.212 is a billable, specific ICD-10-CM code for sickle-cell/hb-c disease with splenic sequestration. It is valid for submission on a claim.
Check D57.212 with the rest of the claim: free scrubberOther codes that can never be billed with D57.212
Their own Excludes1 notes name this code, so the conflict is not listed above.
- D56.8Other thalassemias
Risk adjustment
D57.212 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
D57.212 is named in 19 Medicare coverage policies: 19 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
- A56464Billing and Coding: Flow Cytometry
Alphabetic index entries that lead here
- Disease, diseased›sickle-cell›Hb-C›with›splenic sequestration
Code history
Unchanged in every release from FY2024 to FY2027.
Other codes under D57.21
- D57.211Sickle-cell/Hb-C disease with acute chest syndrome
- D57.213Sickle-cell/Hb-C disease with cerebral vascular involvement
- D57.214Sickle-cell/Hb-C disease with dactylitis
- D57.218Sickle-cell/Hb-C disease with crisis with other specified complication
- D57.219Sickle-cell/Hb-C disease with crisis, unspecified