D57.413

D57.413: Sickle-cell thalassemia, unspecified, with cerebral vascular involvement

Billable / specific codeICD-10-CM

D57.413 is a billable, specific ICD-10-CM code for sickle-cell thalassemia, unspecified, with cerebral vascular involvement. It is valid for submission on a claim.

Check D57.413 with the rest of the claim: free scrubber

Code also

Both codes may be needed to describe the encounter fully. Sequencing depends on the reason for the visit.

, if applicable cerebral infarction (I63.-)

Excludes1 inherited from the categories above D57.413

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 D57.413

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

D56.8Other thalassemias

Risk adjustment

D57.413 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

D57.413 is named in 9 Medicare coverage policies: 9 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

A55717Billing and Coding: Lab: Flow Cytometry
A56758Billing and Coding: Non-Invasive Vascular Studies
A57110Billing and Coding: MolDX: Blood Product Molecular Antigen Typing
A57124Billing and Coding: MolDX: Blood Product Molecular Antigen Typing

Alphabetic index entries that lead here

Microdrepanocytosis›with›cerebral vascular involvement
Disease, diseased›sickle-cell›thalassemia›with›cerebral vascular involvement
Hemoglobinopathy›sickle-cell›with thalassemia›with›cerebral vascular involvement

Code history

Unchanged in every release from FY2024 to FY2027.