ICD-10 Coding for Hemolytic Anemia(D59.11, D59.12)
Complete ICD-10-CM coding and documentation guide for Hemolytic Anemia. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Hemolytic Anemia
D59.0-D59.9Primary Range
Acquired hemolytic anemias
This range includes various types of hemolytic anemias, including autoimmune and drug-induced types.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| D59.11 | Warm autoimmune hemolytic anemia | Use when there is evidence of IgG antibodies active at 37°C. |
|
| D59.12 | Cold agglutinin disease | Use when IgM antibodies are reactive below 10°C. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for warm autoimmune hemolytic anemia
Essential facts and insights about Hemolytic Anemia
Primary ICD-10-CM Codes for hemolytic anemia
Decision Criteria
clinical Criteria
- Positive DAT for IgG without C3d
Applicable To
- IgG-mediated hemolysis
Excludes
- Cold agglutinin disease (D59.12)
Clinical Validation Requirements
- Positive DAT for IgG
- Hemoglobin <10 g/dL
- Reticulocytosis >3%
Code-Specific Risks
- Misclassification if antibody type is not confirmed
Coding Notes
- Ensure antibody type and temperature sensitivity are documented.
D59.12 - Cold agglutinin disease
Use when IgM antibodies are reactive below 10°C.
Applicable To
- IgM-mediated hemolysis
Excludes
- Warm autoimmune hemolytic anemia (D59.11)
Clinical Validation Requirements
- Positive cold agglutinin titer
- Symptoms exacerbated by cold exposure
Coding Notes
Document cold sensitivity and antibody type.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Hemolytic Anemia to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code D59.11.
Impact
Clinical: May lead to inappropriate treatment., Regulatory: Non-compliance with coding standards., Financial: Potential for denied claims.
Mitigation Strategy
Educate clinicians on documentation requirements., Use templates that prompt for specific details.
Impact
Reimbursement: May lead to reduced reimbursement due to lack of specificity., Compliance: Non-compliance with coding guidelines., Data Quality: Decreases accuracy of clinical data.
Mitigation Strategy
Always confirm and document the specific type of hemolytic anemia.
Impact
High risk of audit if unspecified codes are used when specific types are documented.
Mitigation Strategy
Ensure thorough documentation of antibody type and temperature sensitivity.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Hemolytic Anemia, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Hemolytic Anemia
Use these documentation templates to ensure complete and accurate documentation for Hemolytic Anemia. These templates include all required elements for proper coding and billing.
Warm Autoimmune Hemolytic Anemia
Specialty: HematologyRequired Elements
- Positive DAT for IgG
- Hemoglobin level
- Reticulocyte count
- Peripheral smear findings
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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