D57.819

D57.819: Other sickle-cell disorders with crisis, unspecified

Billable / specific codeICD-10-CM

D57.819 is a billable, specific ICD-10-CM code for other sickle-cell disorders with crisis, unspecified. It is valid for submission on a claim.

Check D57.819 with the rest of the claim: free scrubber

Inclusion terms

Alternative wordings a physician may use in the chart for this same code.

Other sickle-cell disorders with crisis NOS
Other sickle-cell disorders with (vaso-occlusive) pain NOS

Excludes1 inherited from the categories above D57.819

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 D57.819

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

D56.8Other thalassemias

Risk adjustment

D57.819 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

D57.819 is named in 14 Medicare coverage policies: 14 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
A56464Billing and Coding: Flow Cytometry
A56718Billing and Coding: Intravenous Immunoglobulin (IVIG)

Alphabetic index entries that lead here

Disease, diseased›sickle-cell›Hb-SD›with›crisis
Disease, diseased›sickle-cell›Hb-SD›with›pain(vaso-occlusive)
Disease, diseased›sickle-cell›Hb-SE›with›crisis
Disease, diseased›sickle-cell›Hb-SE›with›pain(vaso-occlusive)
Disease, diseased›sickle-cell›specified NEC›with›crisis
Disease, diseased›sickle-cell›specified NEC›with›pain(vaso-occlusive)
Disease, diseased›sickle-cell›spherocytosis›with›crisis
Disease, diseased›sickle-cell›spherocytosis›with›pain(vaso-occlusive)

Code history

Unchanged in every release from FY2024 to FY2027.