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ICD-10 Coding for Sickle Cell Disease with Crisis(D57.01, D57.219)

Complete ICD-10-CM coding and documentation guide for Sickle Cell Disease with Crisis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.

Also known as:

Sickle Cell CrisisVaso-occlusive Crisis

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Related ICD-10 Code Ranges

Complete code families applicable to Sickle Cell Disease with Crisis

D57.0-D57.4Primary Range

Sickle-cell disorders

This range includes all sickle cell disorders, with specific codes for crises and complications.

Code Comparison: When to Use Each Code

Compare key differences between these codes to ensure accurate selection

CodeDescriptionWhen to UseKey Documentation
D57.01HbSS with crisisUse when a patient with HbSS genotype presents with an acute pain crisis.
  • Hgb electrophoresis showing HbSS
  • Reticulocyte count >10%
  • Pain crisis documentation
D57.219HbSC with crisisUse when a patient with HbSC genotype presents with an acute pain crisis.
  • Hb electrophoresis showing HbSC
  • Documented pain crisis

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 sickle cell disease with crisis

Essential facts and insights about Sickle Cell Disease with Crisis

The ICD-10 code for sickle cell disease with crisis is D57.01 for HbSS with crisis and D57.219 for HbSC with crisis.

Primary ICD-10-CM Codes for sickle cell disease with crisis

D57.01
HbSS with crisis
Billable Code

Decision Criteria

clinical Criteria

  • Presence of acute pain crisis in HbSS genotype

Applicable To

  • HbSS with acute pain crisis

Excludes

  • Sickle-cell trait (D57.3)

Clinical Validation Requirements

  • Hgb electrophoresis showing HbSS
  • Reticulocyte count >10%
  • Pain crisis documentation

Code-Specific Risks

  • Incorrectly coding as unspecified sickle cell crisis

Coding Notes

  • Ensure to document the specific genotype and crisis type.
View Full Code Details

Ancillary Codes

Additional codes that should be used in conjunction with the main diagnosis codes when applicable.

Acute chest syndrome

J18.9
Use when acute chest syndrome is confirmed by imaging.

Differential Codes

Alternative codes to consider when ruling out similar conditions to the primary diagnosis.

HbSC with crisis

D57.219
Use when Hb electrophoresis confirms HbSC genotype.

HbSS with crisis

D57.01
Use when Hb electrophoresis confirms HbSS genotype.

Documentation & Coding Risks

Avoid these common documentation and coding issues when documenting Sickle Cell Disease with Crisis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code D57.01.

Impact

Clinical: Inadequate treatment planning., Regulatory: Non-compliance with documentation standards., Financial: Potential for denied claims.

Mitigation Strategy

Always ask about recent triggers during patient history.

Impact

Reimbursement: May lead to lower reimbursement rates., Compliance: Non-compliance with coding guidelines., Data Quality: Decreases accuracy of patient records.

Mitigation Strategy

Always specify the genotype and crisis type in documentation.

Impact

Failure to document genotype can lead to audit issues.

Mitigation Strategy

Ensure genotype is documented in every case of sickle cell crisis.

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 Sickle Cell Disease with Crisis, with expert answers to help guide accurate code selection and documentation.

Documentation Templates for Sickle Cell Disease with Crisis

Use these documentation templates to ensure complete and accurate documentation for Sickle Cell Disease with Crisis. These templates include all required elements for proper coding and billing.

Emergency Department Visit for Sickle Cell Crisis

Specialty: Emergency Medicine

Required Elements

  • Genotype documentation
  • Crisis trigger
  • Pain assessment

Example Documentation

Patient presents with HbSS genotype and acute vaso-occlusive crisis triggered by dehydration.

Examples: Poor vs. Good Documentation

Poor Documentation Example
Patient has sickle cell crisis.
Good Documentation Example
Patient with HbSS genotype presents with acute vaso-occlusive crisis triggered by dehydration, severe leg pain.
Explanation
The good example specifies the genotype and crisis details, which are necessary for accurate coding.

Need help with ICD-10 coding for Sickle Cell Disease with Crisis? Ask your questions below.

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