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D57.218 ICD-10-CM Code: Sickle-cell/Hb-C disease with crisis with other specified complication

Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Inpatient Payment Groups (MS-DRG)

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v43.0, Appendix B.

  • MS-DRG 811 — RED BLOOD CELL DISORDERS WITH MCC (MDC 16)
  • MS-DRG 812 — RED BLOOD CELL DISORDERS WITHOUT MCC (MDC 16)

A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.

Risk Adjustment (CMS-HCC)

Payment categories this diagnosis maps to under CMS-HCC V28, payment year 2026.

  • HCC 108 — Sickle Cell Disorders, Except Sickle Cell Anemia (Hb-SS) and Thalassemia Beta Zero; Beta Thalassemia Major

Other models: CMS-HCC V22 HCC 46

Risk scores depend on the enrollee's full accepted diagnosis set and segment; a category mapping alone does not determine payment.

Official Registry Overview & Definition

Sickle-cell/Hb-C disease with crisis with other specified complication is a billable ICD-10-CM diagnosis code (D57.218).

Official Tabular Instructional Notes

Sequencing, inclusion, and exclusion notes published for D57.218 in the official ICD-10-CM tabular list.

Excludes1 — Not Coded Here

Conditions generally not reported together with this code (Excludes1) -- an error unless the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Use Additional Code

Supplementary codes the tabular list directs you to add.

  • Use additional code to identify complications, such as:
  • cholelithiasis (K80.-)
  • priapism (N48.32)
  • Use additional code for any associated fever (R50.81)

Indexed Clinical Terms (2)

Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code.

  • Disease, diseased, sickle-cell, Hb-C, with, crisis, with, specified complication NEC
  • Disease, diseased, sickle-cell, Hb-C, with, priapism

Frequently Compared Codes

The official Excludes notes on D57.218 name these codes. Each comparison page covers when the two can — or must not — be reported together.

Change history

  • FY2021 — 2020-10-01
    Added to the code set
    Sickle-cell/Hb-C disease with crisis with other specified complication
    FY2021 changes

Verify Before Coding

  • MCC as a secondary diagnosis (FY2026). Can raise the stay's MS-DRG severity tier.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim.

Referenced by Other Codes

Clinical classification (AHRQ CCSR):BLD005 — Sickle cell trait/anemia (default).

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Potential MS-DRG Relationships (FY2026)

MCC — Major Complication or Comorbidity. Reported as a secondary diagnosis, this code raises the stay's MS-DRG severity tier — except when the principal diagnosis is one of 49 clinically related codes on its CMS exclusion list.

Named in the grouper logic of 2 MS-DRGs: DRG 811 (MDC 16), DRG 812 (MDC 16).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Official ICD-10-CM tabular notes on other codes that name D57.218 or its code family.

1 Excludes1 notes: D56.8 (via D57.-).

3 Code First instructions across 3 chapters: H36 (via D57.-), M14.8 (via D57.-), R50.81 (via D57.-).

1 Code Also instructions: Z71.87 (via D57.-).

Contextual Map

Every relationship of D57.218 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Hierarchy

  • D50-D89 — Chapter 3: Diseases of the Blood and Blood-forming Organs and Certain Disorders Involving the Immune Mechanism (D50-D89) (D50-D89) [Hierarchy]
  • D55-D59 — Hemolytic anemias [Hierarchy]

Use Additional Code

  • K80 — Cholelithiasis [Use Additional Code]: “cholelithiasis (K80.-)” · check together
  • N48.32 — Priapism due to disease classified elsewhere [Use Additional Code]: “priapism (N48.32)” · check together

Referenced by Excludes1 notes

  • D56.8 — Other thalassemias [Excludes1](via D57.-): “sickle-cell anemia (D57.-)” · check together

Referenced by Code First instructions

  • H36 — Retinal disorders in diseases classified elsewhere [Code First](via D57.-): “sickle-cell disorders (D57.-)” · check together
  • M14.8 — Arthropathies in other specified diseases classified elsewhere [Code First](via D57.-): “sickle-cell disorders (D57.-)” · check together
  • R50.81 — Fever presenting with conditions classified elsewhere [Code First](via D57.-): “sickle-cell disease (D57.-)” · check together

Referenced by Code Also instructions

  • Z71.87 — Encounter for pediatric-to-adult transition counseling [Code Also](via D57.-): “sickle-cell disorder (D57.-)” · check together

Clinical classification (CCSR)

  • BLD005 — Sickle cell trait/anemia [CCSR]

Risk adjustment (CMS-HCC)

  • HCC 108 — Sickle Cell Disorders, Except Sickle Cell Anemia (Hb-SS) and Thalassemia Beta Zero; Beta Thalassemia Major [CMS-HCC]

Potential MS-DRG

  • MCC — Major Complication or Comorbidity [MS-DRG severity]: “As a secondary diagnosis this code can raise the stay's MS-DRG severity tier (MCC).”
  • DRG 811 — RED BLOOD CELL DISORDERS WITH MCC [MS-DRG]: “RED BLOOD CELL DISORDERS WITH MCC (MDC 16)”
  • DRG 812 — RED BLOOD CELL DISORDERS WITHOUT MCC [MS-DRG]: “RED BLOOD CELL DISORDERS WITHOUT MCC (MDC 16)”

MDC crossing · procedures (1614)

  • MDC 16 — Diseases and Disorders of Blood, Blood Forming Organs and Immunologic Disorders [MDC crossing]: “Diseases and Disorders of Blood, Blood Forming Organs and Immunologic Disorders — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs.”
  • 02HV02Z — Insertion of Monitoring Device into Superior Vena Cava, Open Approach [Same-MDC procedure]: “Insertion of Monitoring Device into Superior Vena Cava, Open Approach — grouped in MDC 16, the procedure side of this code's crossing.” · check together
  • 02HV0DZ — Insertion of Intraluminal Device into Superior Vena Cava, Open Approach [Same-MDC procedure]: “Insertion of Intraluminal Device into Superior Vena Cava, Open Approach — grouped in MDC 16, the procedure side of this code's crossing.” · check together
  • 02HV3DZ — Insertion of Intraluminal Device into Superior Vena Cava, Percutaneous Approach [Same-MDC procedure]: “Insertion of Intraluminal Device into Superior Vena Cava, Percutaneous Approach — grouped in MDC 16, the procedure side of this code's crossing.” · check together
  • 02HV42Z — Insertion of Monitoring Device into Superior Vena Cava, Percutaneous Endoscopic Approach [Same-MDC procedure]: “Insertion of Monitoring Device into Superior Vena Cava, Percutaneous Endoscopic Approach — grouped in MDC 16, the procedure side of this code's crossing.” · check together
  • 02HV4DZ — Insertion of Intraluminal Device into Superior Vena Cava, Percutaneous Endoscopic Approach [Same-MDC procedure]: “Insertion of Intraluminal Device into Superior Vena Cava, Percutaneous Endoscopic Approach — grouped in MDC 16, the procedure side of this code's crossing.” · check together
  • and 1609 more

Index entries

  • Disease, diseased, sickle-cell, Hb-C, with, crisis, with, specified complication NEC[Index term]
  • Disease, diseased, sickle-cell, Hb-C, with, priapism[Index term]

Nearest codes (40)

  • D57 — Sickle-cell disorders [Sibling]
  • D57.0 — Hb-SS disease with crisis [Sibling]
  • D57.00 — Hb-SS disease with crisis, unspecified [Sibling]
  • D57.01 — Hb-SS disease with acute chest syndrome [Sibling]
  • D57.02 — Hb-SS disease with splenic sequestration [Sibling]
  • D57.03 — Hb-SS disease with cerebral vascular involvement [Sibling]
  • D57.04 — Hb-SS disease with dactylitis [Sibling]
  • D57.09 — Hb-SS disease with crisis with other specified complication [Sibling]
  • and 32 more

Change history

  • FY2021 — Added to the code set [Change history]

Nearest Codes in This Family

Official ICD-10-CM classifications closest to D57.218 in its code family, with their registry titles.

  • D57.21 — Sickle-cell/Hb-C disease with crisis
  • D57.211 — Sickle-cell/Hb-C disease with acute chest syndrome
  • D57.212 — Sickle-cell/Hb-C disease with splenic sequestration
  • D57.213 — Sickle-cell/Hb-C disease with cerebral vascular involvement
  • D57.214 — Sickle-cell/Hb-C disease with dactylitis
  • D57.219 — Sickle-cell/Hb-C disease with crisis, unspecified
  • D57.3 — Sickle-cell trait
  • D57.4 — Sickle-cell thalassemia
  • D57.40 — Sickle-cell thalassemia without crisis
  • D57.41 — Sickle-cell thalassemia, unspecified, with crisis

View all codes in the D57 family