Is D59.5 a billable ICD-10-CM code?

Yes. D59.5 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does D59.5 sit in the tabular list?

Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism (D50-D89), in the block Hemolytic anemias (D55-D59).

What cannot be coded together with D59.5?

D59.5 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.

D59.5

D59.5 — Paroxysmal nocturnal hemoglobinuria [Marchiafava-Micheli]

Billable / specific codeICD-10-CM

D59.5 is a billable, specific ICD-10-CM code for paroxysmal nocturnal hemoglobinuria [marchiafava-micheli]. It is valid for submission on a claim.

Excludes1 — never code together

These conditions cannot occur together. Billing both on the same encounter is a denial.

hemoglobinuria NOS (R82.3)

Other codes that can never be billed with D59.5

These codes carry an Excludes1 note pointing at D59.5. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading D59.5 alone.

R82.3Hemoglobinuria

Risk adjustment

D59.5 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:

HCC 109 Acquired Hemolytic, Aplastic, and Sideroblastic Anemias1.144 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.

Medicare coverage

D59.5 is named in 4 Medicare coverage policies — 4 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A54548Billing and Coding: Eculizumab, and Biosimilars: EPYSQLI®-eculizumab-aagh, and BKEMV™-eculizumab-aeeb
A55717Billing and Coding: Lab: Flow Cytometry
A56464Billing and Coding: Flow Cytometry
A57689Billing and Coding: Lab: Flow Cytometry

How D59.5 is indexed

Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to D59.5.

Marchiafava-Micheli syndrome
Hemoglobinuria›nocturnal(paroxysmal)
Hematuria›paroxysmal›nocturnal
Hemoglobinemia›paroxysmal›nocturnal
Hemoglobinuria›paroxysmal›nocturnal

Related codes at this level

Codes that share D59. If D59.5 is not quite right, the correct code is usually one of these.

Questions about D59.5

Is D59.5 a billable ICD-10-CM code?: Yes. D59.5 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does D59.5 sit in the tabular list?: Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism (D50-D89), in the block Hemolytic anemias (D55-D59).
What cannot be coded together with D59.5?: D59.5 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.