D57.459: Sickle-cell thalassemia beta plus with crisis, unspecified
D57.459 is a billable, specific ICD-10-CM code for sickle-cell thalassemia beta plus with crisis, unspecified. It is valid for submission on a claim.
Check D57.459 with the rest of the claim: free scrubberInclusion terms
Alternative wordings a physician may use in the chart for this same code.
- HbS-beta plus with crisis with unspecified complication
- Sickle-cell beta plus with crisis with unspecified complication
- Sickle-cell thalassemia beta plus with (painful) crisis NOS
- Sickle-cell thalassemia beta plus with (vaso-occlusive) pain NOS
Other codes that can never be billed with D57.459
Their own Excludes1 notes name this code, so the conflict is not listed above.
- D56.8Other thalassemias
Risk adjustment
D57.459 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
D57.459 is named in 11 Medicare coverage policies: 11 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A55717Billing and Coding: Lab: Flow Cytometry
- A56421Billing and Coding: CT of the Abdomen and Pelvis
- A56464Billing and Coding: Flow Cytometry
- A56580Billing and Coding: Computerized Axial Tomography (CT), Thorax
Alphabetic index entries that lead here
- Disease, diseased›hemoglobin or Hb›S or SS›beta plus›with›crisis
- Disease, diseased›hemoglobin or Hb›S or SS›beta plus›with›pain(vaso-occlusive)
- Disease, diseased›sickle-cell›thalassemia›beta plus›with›crisis
- Disease, diseased›sickle-cell›thalassemia›beta plus›with›pain(vaso-occlusive)
Code history
Unchanged in every release from FY2024 to FY2027.
Other codes under D57.45
- D57.451Sickle-cell thalassemia beta plus with acute chest syndrome
- D57.452Sickle-cell thalassemia beta plus with splenic sequestration
- D57.453Sickle-cell thalassemia beta plus with cerebral vascular involvement
- D57.454Sickle-cell thalassemia beta plus with dactylitis
- D57.458Sickle-cell thalassemia beta plus with crisis with other specified complication