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D59.39 ICD-10-CM Code: Other hemolytic-uremic syndrome

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

Coding at a Glance

Tabular directives
2 inclusion terms · 1 use-additional code · 5 code-first instructions · 7 code-also instructions
Risk adjustment
CMS-HCC V28: 1 category · CMS-HCC V22 category 46 · RxHCC V08 category 96

Inpatient Payment Groups (MS-DRG)

Potential MS-DRG participation — not a DRG assignment.

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v43, 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 109 — Acquired Hemolytic, Aplastic, and Sideroblastic Anemias

Other models: CMS-HCC V22 HCC 46 · RxHCC V08 HCC 96

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

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for D59.39 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2026Effective: October 1, 2025

Notes without a marker are published on D59.39 itself; “inherited from” names the category or block whose note applies here.

Inclusion Terms

Alternative terms the tabular list files under this code.

  • Atypical (nongenetic) hemolytic uremic syndrome
  • Secondary hemolytic-uremic syndrome

Code First

Underlying conditions that must be sequenced before this code.

  • Code first, if applicable, any associated:
  • COVID-19 (U07.1)
  • complications of kidney transplant (T86.1-)
  • complications of heart transplant (T86.2-)
  • complications of liver transplant (T86.4-)

Code Also

Additional codes that may be required to fully describe the encounter.

  • Code also, if applicable, any associated condition, such as:
  • hypertensive emergency (I16.1)
  • malignant neoplasm (C00-C96)
  • systemic lupus erythematosus (M32.-)
  • Code also, if applicable, any associated:
  • acute kidney failure (N17.-) inherited from D59.3
  • chronic kidney disease (N18.-) inherited from D59.3

Use Additional Code

Supplementary codes the tabular list directs you to add.

  • Use additional code, if applicable, for adverse effect to identify drug (T36-T50 with fifth or sixth character 5)

Coder workflow for D59.39

MedCoder structured workflow — derived from this code’s own official record

Before you code D59.39

  1. “Other” (NEC) means the condition is specified in the record but no dedicated code captures it. Confirm the documented form is not one a sibling code names before settling on D59.39; if the record states no specifics at all, the unspecified sibling applies instead. “Other” codes are for documented conditions the classification gives no specific code; “unspecified” codes are for records lacking the detail (Guidelines I.A.9.a, I.A.9.b).

    ReviewD59.31, D59.32

    See the relationships section · Guide: Other vs unspecified (NEC vs NOS) →

Choose the right path

  1. Is the underlying (etiologic) condition the Code First note names documented?
    Yes → Sequence the underlying condition first, then D59.39.
    No → Continue; do not add an underlying condition the record does not document.

    ReviewT86.1, T86.2, T86.4

Consider D59.39. Then work the Use Additional Code note and review the Code Also note, and confirm the code is valid for the date of service in the Verify section.

Documentation check

The provider’s diagnostic statement
Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).
The underlying (etiologic) condition
Named in the Code First note; sequenced before this code when documented (Guidelines I.A.13).
The conditions the Use Additional Code note names
Reported with this code when documented; a conditional instruction (“if applicable”, “if known”) applies only when the record supports it.
Any detail beyond this code’s title
What the record states that a more specific sibling code would capture — or its absence, which itself supports the unspecified code.

Official instructions as workflow

  • Code First — sequencing check(5 notes)

    Coding workflow: Check whether the underlying or etiologic condition the note names is documented. When it is, sequence it before D59.39. Do not add an underlying condition the record does not document.

    ReviewT86.1, T86.2, T86.4

    See the official tabular notes · Guidelines I.A.13

  • Use Additional Code — after identifying D59.39(1 note)

    Coding workflow: Check whether the documentation supports the additional code(s) the note names, and report them with D59.39 when it does. Where the instruction is conditional (“if applicable”, “if known”), it applies only when the record documents the condition.

    See the official tabular notes · Guidelines I.A.13

  • Code Also — related condition(7 notes)

    Coding workflow: Review the related condition when both are documented and the instruction applies. A Code Also note does not fix sequencing; the order follows the circumstances of the encounter.

    ReviewI16.1, M32, N17, N18

    See the official tabular notes · Guidelines I.A.17

Coding decision scenarios

Pattern scenarios for this code’s structure — decision rules, not clinical cases

Documentation: The underlying condition the Code First note names is documented alongside this condition.

Coding question: How are the two sequenced?

Path: Review the Code First note.

Reason: The underlying condition is sequenced first and the manifestation follows (Guidelines I.A.13).

ReviewT86.1, T86.2, T86.4

Documentation: A condition the Use Additional Code note names is documented.

Coding question: Is a second code reported with D59.39?

Path: Review the Use Additional Code note and the code it names.

Reason: The additional code is reported when the record documents the condition; a conditional instruction applies only when its condition is met (Guidelines I.A.13).

Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.

Code Overview

Other hemolytic-uremic syndrome is a billable ICD-10-CM diagnosis code (D59.39).

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

Indexed Clinical Terms (5)

Official source data — entries quoted as published, in the Index’s own lookup phrasing

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.

Official Coding Guidelines

No excerpt in the ICD-10-CM Official Guidelines names this code specifically. Its chapter carries only this chapter-wide note:

Chapter 3: Disease of the blood and blood-forming organs and certain disorders involving the immune mechanism (D50-D89)

Reserved for future guideline expansion

Decision Points

The directives on this code's own record, as a pre-claim checklist.

  1. Sequencing: 5 Code First instructions — the underlying condition is sequenced before this code when present. See the Code First notes
  2. 1 Use Additional Code instruction — report the named additional code(s) when the documentation supports them. See the Use Additional Code notes
  3. 7 Code Also notes — a second code may apply; the guidelines leave its sequencing to the circumstances of the encounter. See the Code Also notes

Checklist rows are derived from this code's own official directives; the wording of each check is MedCoder editorial. The official notes themselves are in the sections each row links to.

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

MedCoder structured relationships — computed from published CMS and AHRQ datasets

Other codes that name D59.39 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 3 Excludes1 notes across 3 chapters: D69.1 — Qualitative platelet defects (via D59.3.-), N08 — Glomerular disorders in diseases classified elsewhere (via D59.3.-), R71 — Abnormality of red blood cells (via D59.-).

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

Referenced by 4 Excludes2 notes: N17 — Acute kidney failure (via D59.3.-), N17-N19 — Acute kidney failure and chronic kidney disease (N17-N19) (via D59.3.-), N18 — Chronic kidney disease (CKD) (via D59.3.-), N19 — Unspecified kidney failure (via D59.3.-).

These codes’ tabular lists name this diagnosis as distinct — both may be reported when both are documented.

Referenced by 23 Code First instructions across 3 chapters: I21.A1 — Myocardial infarction type 2 (via D59.-), M90.5 — Osteonecrosis in diseases classified elsewhere (via D59.-), T36 — Poisoning by, adverse effect of and underdosing of systemic antibiotics (via D59.-), T36-T39 — Antibiotics & Anti-infectives (T36-T39) (via D59.-), T36-T50 — Poisoning by, adverse effects of and underdosing of drugs, medicaments and biological substances (T36-T50) (via D59.-), T37 — Poisoning by, adverse effect of and underdosing of other systemic anti-infectives and antiparasitics (via D59.-), T38 — Poisoning by, adverse effect of and underdosing of hormones and their synthetic substitutes and antagonists, not elsewhere classified (via D59.-), T39 — Poisoning by, adverse effect of and underdosing of nonopioid analgesics, antipyretics and antirheumatics (via D59.-), T40 — Poisoning by, adverse effect of and underdosing of narcotics and psychodysleptics [hallucinogens] (via D59.-), T40-T41 — Analgesics & Antipyretics (T40-T41) (via D59.-), T41 — Poisoning by, adverse effect of and underdosing of anesthetics and therapeutic gases (via D59.-), T42 — Poisoning by, adverse effect of and underdosing of antiepileptic, sedative- hypnotic and antiparkinsonism drugs (via D59.-), T42-T43 — Anticonvulsants & Psychotropics (T42-T43) (via D59.-), T43 — Poisoning by, adverse effect of and underdosing of psychotropic drugs, not elsewhere classified (via D59.-), T44 — Poisoning by, adverse effect of and underdosing of drugs primarily affecting the autonomic nervous system (via D59.-), T44-T46 — Cardiovascular & Gastrointestinal (T44-T46) (via D59.-), T45 — Poisoning by, adverse effect of and underdosing of primarily systemic and hematological agents, not elsewhere classified (via D59.-), T46 — Poisoning by, adverse effect of and underdosing of agents primarily affecting the cardiovascular system (via D59.-), T47 — Poisoning by, adverse effect of and underdosing of agents primarily affecting the gastrointestinal system (via D59.-), T47-T50 — Hormones & Systemic Agents (T47-T50) (via D59.-), +3 more.

Each of these codes carries a Code First note naming this condition — when that code is reported, THIS code is sequenced first, ahead of it.

Referenced by 1 Use Additional Code instruction: M31.11 — Hematopoietic stem cell transplantation-associated thrombotic microangiopathy [HSCT-TMA] (via D59.3.-).

These codes instruct coders to additionally report this code when it applies.

MS-DRG Grouper Relationships (FY2026)

Potential MS-DRG participation — not a DRG assignment.

FY2026 MS-DRG: 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 110 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):BLD002 — Hemolytic 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.

D59.0 — Drug-induced autoimmune hemolytic anemia, D59.10 — Autoimmune hemolytic anemia, unspecified, D59.11 — Warm autoimmune hemolytic anemia, D59.12 — Cold autoimmune hemolytic anemia, D59.13 — Mixed type autoimmune hemolytic anemia, D59.19 — Other autoimmune hemolytic anemia, D59.2 — Drug-induced nonautoimmune hemolytic anemia, D59.30 — Hemolytic-uremic syndrome, unspecified, D59.31 — Infection-associated hemolytic-uremic syndrome, D59.32 — Hereditary hemolytic-uremic syndrome, D59.4 — Other nonautoimmune hemolytic anemias, D59.5 — Paroxysmal nocturnal hemoglobinuria [Marchiafava-Micheli], D59.6 — Hemoglobinuria due to hemolysis from other external causes, D59.8 — Other acquired hemolytic anemias, D59.9 — Acquired hemolytic anemia, unspecified, D60.0 — Chronic acquired pure red cell aplasia, D60.1 — Transient acquired pure red cell aplasia, D60.8 — Other acquired pure red cell aplasias, D60.9 — Acquired pure red cell aplasia, unspecified, D61.01 — Constitutional (pure) red blood cell aplasia, +89 more

Same CMS-HCC risk category (V28)

CMS maps these diagnoses to the same Hierarchical Condition Category (Acquired Hemolytic, Aplastic, and Sideroblastic Anemias) for risk-adjusted payment.

D59.10 — Autoimmune hemolytic anemia, unspecified, D59.11 — Warm autoimmune hemolytic anemia, D59.12 — Cold autoimmune hemolytic anemia, D59.13 — Mixed type autoimmune hemolytic anemia, D59.19 — Other autoimmune hemolytic anemia, D59.30 — Hemolytic-uremic syndrome, unspecified, D59.31 — Infection-associated hemolytic-uremic syndrome, D59.32 — Hereditary hemolytic-uremic syndrome, D59.4 — Other nonautoimmune hemolytic anemias, D59.5 — Paroxysmal nocturnal hemoglobinuria [Marchiafava-Micheli], D59.6 — Hemoglobinuria due to hemolysis from other external causes, D59.8 — Other acquired hemolytic anemias, D59.9 — Acquired hemolytic anemia, unspecified, D60.0 — Chronic acquired pure red cell aplasia, D60.8 — Other acquired pure red cell aplasias, D60.9 — Acquired pure red cell aplasia, unspecified, D61.01 — Constitutional (pure) red blood cell aplasia, D61.02 — Shwachman-Diamond syndrome, D61.03 — Fanconi anemia, D61.09 — Other constitutional aplastic anemia, +16 more

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Hemolytic anemia).

D58.2 — Other hemoglobinopathies, D58.8 — Other specified hereditary hemolytic anemias, D58.9 — Hereditary hemolytic anemia, unspecified, D59.0 — Drug-induced autoimmune hemolytic anemia, D59.1 — Other autoimmune hemolytic anemias, D59.10 — Autoimmune hemolytic anemia, unspecified, D59.11 — Warm autoimmune hemolytic anemia, D59.12 — Cold autoimmune hemolytic anemia, D59.13 — Mixed type autoimmune hemolytic anemia, D59.19 — Other autoimmune hemolytic anemia, D59.2 — Drug-induced nonautoimmune hemolytic anemia, D59.3 — Hemolytic-uremic syndrome, D59.30 — Hemolytic-uremic syndrome, unspecified, D59.31 — Infection-associated hemolytic-uremic syndrome, D59.32 — Hereditary hemolytic-uremic syndrome, D59.4 — Other nonautoimmune hemolytic anemias, D59.5 — Paroxysmal nocturnal hemoglobinuria [Marchiafava-Micheli], D59.6 — Hemoglobinuria due to hemolysis from other external causes, D59.8 — Other acquired hemolytic anemias, D59.9 — Acquired hemolytic anemia, unspecified, +18 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.

HIV Screening Test

Contextual Map

Every relationship of D59.39 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.

Run D59.39 with these 24 related codes in Claim Check

Hierarchy

Code First

Use Additional Code (15)

Code Also

Referenced by Excludes1 notes

Referenced by Excludes2 notes

Referenced by Code First instructions (23)

Referenced by Use Additional Code instructions

Clinical classification (CCSR)

Risk adjustment (CMS-HCC)

  • HCC 109 — Acquired Hemolytic, Aplastic, and Sideroblastic Anemias [CMS-HCC]— CMS-HCC V28 · 2026

MS-DRG Grouper

MDC crossing

Index entries

  • Syndrome, hemolytic-uremic, atypical[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Syndrome, hemolytic-uremic, atypical, secondary[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Syndrome, hemolytic-uremic, atypical, specified NEC[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Syndrome, hemolytic-uremic, secondary[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Syndrome, hemolytic-uremic, specified NEC[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026

Nearest codes (18)

Change history

Sources for this page

Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.

Code, title, tabular notes and index terms Official source data
CMS/CDC ICD-10-CM FY2026 tabular list, index and tables, effective October 1, 2025 Release, file and checksum · Publisher’s page
Coding guidelines Official source data
ICD-10-CM Official Guidelines for Coding and Reporting (FY2026), quoted by section Release, file and checksum · Publisher’s page
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v43.1 (April 2026) Release, file and checksum · Publisher’s page
Inpatient payment groups Official source data
CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v43 Release, file and checksum · Publisher’s page
Risk adjustment Official source data
2026 Mid-Year Final ICD-10 Mappings + Model Software (cms.gov/files/zip/2026-midyear-final-icd-10-mappings.zip, 2026-midyear-final-model-software.zip) — CMS-HCC V28, PY2026 mid-year final release Release, file and checksum · Publisher’s page
Change history and date-of-service validity Official source data
CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page
Comparisons, relationships and the contextual map MedCoder structured relationship
Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
Summary and FAQ answers MedCoder explanation
Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.

Labels on this page: Official source data · MedCoder structured relationship · MedCoder explanation. How to read the labels · All data sources and release dates

Cite this page

Reference this page in a research guide, syllabus or article. The release is included because code content changes each year.

MedCoder.ai. "D59.39 — Other hemolytic-uremic syndrome." ICD-10-CM FY2026. https://medcoder.ai/icd10/code/d59.39-other-hemolytic-uremic-syndrome

Change history

  • FY2023 — October 1, 2022
    Added to the code set
    Other hemolytic-uremic syndrome
    FY2023 changes

Nearest Codes in This Family

Official ICD-10-CM classifications closest to D59.39 in its code family, with their registry titles.

View all codes in the D59 family