ICD-10 Coding for Sickle Cell Pain Crisis(D57.00, D57.219, D57.40)
Complete ICD-10-CM coding and documentation guide for Sickle Cell Pain Crisis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Sickle Cell Pain Crisis
D57.0-D57.8Primary Range
Sickle-cell disorders
This range includes all sickle-cell disorders, including those with crisis.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| D57.00 | Sickle-cell anemia without crisis | Use for chronic management without acute crisis. |
|
| D57.219 | Sickle-cell/Hb-C disease with crisis | Use during acute crisis in patients with Hb SC disease. |
|
| D57.40 | Sickle-cell thalassemia with crisis | Use for crisis in patients with sickle-cell thalassemia. |
|
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 pain crisis
Essential facts and insights about Sickle Cell Pain Crisis
Primary ICD-10-CM Codes for sickle cell pain crisis
Decision Criteria
clinical Criteria
- Patient is stable with no acute symptoms.
Applicable To
- Stable sickle-cell anemia
Excludes
- Sickle-cell anemia with crisis (D57.00)
Clinical Validation Requirements
- Stable hemoglobin levels
- No acute pain episodes
Code-Specific Risks
- Misuse during acute crisis
Coding Notes
- Ensure no crisis symptoms are present.
D57.219 - Sickle-cell/Hb-C disease with crisis
Use during acute crisis in patients with Hb SC disease.
Applicable To
- Acute pain crisis in Hb SC disease
Excludes
- Sickle-cell anemia without crisis (D57.00)
Clinical Validation Requirements
- Pain score ≥7/10
- Elevated lactate dehydrogenase (LDH) >300 U/L
- Reticulocytosis >3%
Coding Notes
Ensure documentation of crisis symptoms and lab findings.
D57.40 - Sickle-cell thalassemia with crisis
Use for crisis in patients with sickle-cell thalassemia.
Applicable To
- Crisis in Sβ-thalassemia
Excludes
- Sickle-cell thalassemia without crisis (D57.3)
Clinical Validation Requirements
- Microcytosis (MCV <80 fL)
- Hb electrophoresis confirmation
Coding Notes
Document genotype and crisis symptoms clearly.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Acute respiratory failure with hypoxia
J96.01Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Sickle Cell Pain Crisis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code D57.00.
Impact
Clinical: Inadequate treatment planning, Regulatory: Non-compliance with coding standards, Financial: Potential reimbursement loss
Mitigation Strategy
Use standardized templates, Regular training on documentation standards
Impact
Reimbursement: Incorrect DRG assignment, Compliance: Non-compliance with coding guidelines, Data Quality: Inaccurate patient records
Mitigation Strategy
Verify genotype with electrophoresis before coding.
Impact
High error rate in coding Hb SC vs. Hb SS
Mitigation Strategy
Require genotype confirmation via lab tests
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 Pain Crisis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Sickle Cell Pain Crisis
Use these documentation templates to ensure complete and accurate documentation for Sickle Cell Pain Crisis. These templates include all required elements for proper coding and billing.
Emergency Department Visit for VOC
Specialty: Emergency MedicineRequired Elements
- Pain assessment
- Lab results
- Imaging findings
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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