Skip to main content

D57.412 ICD-10-CM Code: Sickle-cell thalassemia, unspecified, with splenic sequestration

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 791 — PREMATURITY WITH MAJOR PROBLEMS (MDC 15)
  • MS-DRG 793 — FULL TERM NEONATE WITH MAJOR PROBLEMS (MDC 15)
  • 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.

Code Overview

Sickle-cell thalassemia, unspecified, with splenic sequestration is a billable ICD-10-CM diagnosis code (D57.412).

Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.

Official Tabular Instructional Notes

Sequencing, inclusion, and exclusion notes published for D57.412 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 for any associated fever (R50.81) inherited from D57

Indexed Clinical Terms (3)

Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code. These are alphabetic-index entries shown as the Index writes them — lookup phrasing, not necessarily the wording of a final diagnosis.

  • Disease, diseased, sickle-cell, thalassemia, with, splenic sequestration
  • Hemoglobinopathy (mixed), sickle-cell, with thalassemia, with, splenic sequestration
  • Microdrepanocytosis, with, splenic sequestration

Frequently Compared Codes

The official Excludes notes on D57.412 name these codes. Each comparison page covers when the two can — or must not — be reported together.

Change history

  • FY2021 — 2020-10-01
    Description revised
    Sickle-cell thalassemia with splenic sequestration → Sickle-cell thalassemia, unspecified, with splenic sequestration
    FY2021 changes
  • FY2021 — 2020-10-01
    Short description revised
    Sickle-cell thalassemia with splenic sequestration → Sickle-cell thalassemia, unsp, with splenic sequestration
    FY2021 changes
  • FY2016 — 2015-10-01
    In the code set at ICD-10-CM adoption
    Sickle-cell thalassemia with splenic sequestration

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 in Claim Check.

Relationships & Classification

Other codes that name D57.412 or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.

Referenced by 4 Excludes1 notes: D56 (via D57.4.-), D56.1 (via D57.4.-), D56.5 (via D57.4.-), D56.8 (via D57.-).

These codes’ tabular lists mark this diagnosis as mutually exclusive — not reported together unless the conditions are documented as unrelated.

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

These codes instruct coders to sequence this condition first when it applies.

Referenced by 1 Code Also instruction: Z71.87 (via D57.-).

These codes suggest coding this condition alongside when both are present.

MS-DRG Grouper 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 125 clinically related codes on its CMS exclusion list.

Named in the grouper logic of 4 MS-DRGs: DRG 791 (MDC 15), DRG 793 (MDC 15), 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.

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.

Related Codes

Same clinical process (MS-DRG)

Acts as MCC — raises the severity of other admissions. CMS groups these diagnoses into one MS-DRG principal-diagnosis exclusion process — a CC/MCC on this list never raises severity when the principal diagnosis is also on it.

D57.04 — Hb-SS disease with dactylitis, D57.09 — Hb-SS disease with crisis with other specified complication, D57.1 — Sickle-cell disease without crisis, D57.20 — Sickle-cell/Hb-C disease without crisis, D57.211 — Sickle-cell/Hb-C disease with acute chest syndrome, D57.212 — Sickle-cell/Hb-C disease with splenic sequestration, D57.219 — Sickle-cell/Hb-C disease with crisis, unspecified, D57.3 — Sickle-cell trait, D57.40 — Sickle-cell thalassemia without crisis, D57.411 — Sickle-cell thalassemia, unspecified, with acute chest syndrome, D57.413 — Sickle-cell thalassemia, unspecified, with cerebral vascular involvement, D57.414 — Sickle-cell thalassemia, unspecified, with dactylitis, D57.418 — Sickle-cell thalassemia, unspecified, with crisis with other specified complication, D57.419 — Sickle-cell thalassemia, unspecified, with crisis, D57.42 — Sickle-cell thalassemia beta zero without crisis, D57.431 — Sickle-cell thalassemia beta zero with acute chest syndrome, D57.432 — Sickle-cell thalassemia beta zero with splenic sequestration, D57.433 — Sickle-cell thalassemia beta zero with cerebral vascular involvement, D57.434 — Sickle-cell thalassemia beta zero with dactylitis, D57.438 — Sickle-cell thalassemia beta zero with crisis with other specified complication, +104 more

Same CMS-HCC risk category (V28)

CMS maps these diagnoses to the same Hierarchical Condition Category (Sickle Cell Disorders, Except Sickle Cell Anemia (Hb-SS) and Thalassemia Beta Zero; Beta Thalassemia Major) for risk-adjusted payment.

D56.5 — Hemoglobin E-beta thalassemia, D57.20 — Sickle-cell/Hb-C disease without 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, D57.218 — Sickle-cell/Hb-C disease with crisis with other specified complication, D57.219 — Sickle-cell/Hb-C disease with crisis, unspecified, D57.40 — Sickle-cell thalassemia without crisis, D57.411 — Sickle-cell thalassemia, unspecified, with acute chest syndrome, D57.413 — Sickle-cell thalassemia, unspecified, with cerebral vascular involvement, D57.414 — Sickle-cell thalassemia, unspecified, with dactylitis, D57.418 — Sickle-cell thalassemia, unspecified, with crisis with other specified complication, D57.419 — Sickle-cell thalassemia, unspecified, with crisis, D57.44 — Sickle-cell thalassemia beta plus without crisis, D57.451 — Sickle-cell thalassemia beta plus with acute chest syndrome, D57.452 — Sickle-cell thalassemia beta plus with splenic sequestration, D57.453 — Sickle-cell thalassemia beta plus with cerebral vascular involvement, D57.454 — Sickle-cell thalassemia beta plus with dactylitis, D57.458 — Sickle-cell thalassemia beta plus with crisis with other specified complication, +18 more

Related risk categories

These categories interact through CMS's HCC hierarchy — one can suppress the other's risk-adjustment weight when both are present on a claim.

Sickle Cell Anemia (Hb-SS) and Thalassemia Beta Zero

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Sickle cell trait/anemia).

D57.20 — Sickle-cell/Hb-C disease without 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, D57.218 — Sickle-cell/Hb-C disease with crisis with other specified complication, D57.219 — Sickle-cell/Hb-C disease with crisis, unspecified, D57.3 — Sickle-cell trait, D57.40 — Sickle-cell thalassemia without crisis, D57.411 — Sickle-cell thalassemia, unspecified, with acute chest syndrome, D57.413 — Sickle-cell thalassemia, unspecified, with cerebral vascular involvement, D57.414 — Sickle-cell thalassemia, unspecified, with dactylitis, D57.418 — Sickle-cell thalassemia, unspecified, with crisis with other specified complication, D57.419 — Sickle-cell thalassemia, unspecified, with crisis, D57.42 — Sickle-cell thalassemia beta zero without crisis, D57.431 — Sickle-cell thalassemia beta zero with acute chest syndrome, D57.432 — Sickle-cell thalassemia beta zero with splenic sequestration, D57.433 — Sickle-cell thalassemia beta zero with cerebral vascular involvement, D57.434 — Sickle-cell thalassemia beta zero with dactylitis, D57.438 — Sickle-cell thalassemia beta zero with crisis with other specified complication, +30 more

Lab tests where this diagnosis supports Medicare coverage (NCD)

Medicare's National Coverage Determination (NCD) program lists this diagnosis as medical justification for these lab tests.

Gamma-glutamyl Transferase (GGT) Test, Iron Panel

Contextual Map

Every relationship of D57.412 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]

Referenced by Excludes1 notes

  • D56 — Thalassemia [Excludes1](via D57.4.-): “sickle-cell thalassemia (D57.4-)” · check together
  • D56.1 — Beta thalassemia [Excludes1](via D57.4.-): “sickle-cell beta thalassemia (D57.4-)” · check together
  • D56.5 — Hemoglobin E-beta thalassemia [Excludes1](via D57.4.-): “sickle-cell beta thalassemia (D57.4-)” · check together
  • 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]

MS-DRG Grouper

  • 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 791 — PREMATURITY WITH MAJOR PROBLEMS [MS-DRG]: “PREMATURITY WITH MAJOR PROBLEMS (MDC 15)”
  • DRG 793 — FULL TERM NEONATE WITH MAJOR PROBLEMS [MS-DRG]: “FULL TERM NEONATE WITH MAJOR PROBLEMS (MDC 15)”
  • 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 15 — Newborns and Other Neonates with Conditions Originating in Perinatal Period [MDC crossing]: “Newborns and Other Neonates with Conditions Originating in Perinatal Period — 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.”
  • 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.”
  • and 1614 more

Index entries

  • Disease, diseased, sickle-cell, thalassemia, with, splenic sequestration[Index term]
  • Hemoglobinopathy (mixed), sickle-cell, with thalassemia, with, splenic sequestration[Index term]
  • Microdrepanocytosis, with, splenic sequestration[Index term]

Nearest codes (40)

  • D57 — Sickle-cell disorders [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]
  • D57.1 — Sickle-cell disease without crisis [Sibling]
  • D57.2 — Sickle-cell/Hb-C disease [Sibling]
  • and 32 more

Change history (3)

  • FY2021 — Description revised [Change history]
  • and 2 more

Nearest Codes in This Family

Official ICD-10-CM classifications closest to D57.412 in its code family, with their registry titles.

  • 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
  • D57.411 — Sickle-cell thalassemia, unspecified, with acute chest syndrome
  • D57.413 — Sickle-cell thalassemia, unspecified, with cerebral vascular involvement
  • D57.414 — Sickle-cell thalassemia, unspecified, with dactylitis
  • D57.418 — Sickle-cell thalassemia, unspecified, with crisis with other specified complication
  • D57.419 — Sickle-cell thalassemia, unspecified, with crisis
  • D57.42 — Sickle-cell thalassemia beta zero without crisis

View all codes in the D57 family