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
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).
- other hemoglobinopathies (D58.-) Compare D57.218 vs D58 →
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 — 2020-10-01Added to the code setSickle-cell/Hb-C disease with crisis with other specified complicationFY2021 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