Thalassemia
In Hemolytic anemias (D55-D59), chapter 3: Diseases of the Blood and Blood-Forming Organs
8 billable codes under D56: none are a CC or MCC; 3 map to HCC 108 (Sickle Cell Disorders, Except Sickle Cell Anemia (Hb-SS) and Thalassemia Beta Zero; Beta Thalassemia Major).An HCC counts toward a Medicare Advantage patient's risk score.
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Instructional notes
Excludes1: not coded here, use a different code
- sickle-cell thalassemia (D57.4-)
Official coding guidelines
From the ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027 (CMS and NCHS). Links open the PDF at the right page.
There are no chapter-specific rules for Chapter 3 yet, so the general rules in Section I.B apply.
All codes under D56
D56 can't be used on a claim. Pick a billable code below; grey headings group them.
D56 MS-DRGs
As the principal diagnosis, the billable codes under D56 group to MS-DRG 811, 812, 791, or 793 (v44.0). Which one applies depends on procedures performed, secondary diagnoses (CC/MCC), and the patient's age and discharge status.
- DRG 811 Red Blood Cell Disorders with MCC (8 of 8 codes)
- DRG 812 Red Blood Cell Disorders without MCC (8 of 8 codes)
- DRG 791 Prematurity with Major Problems (6 of 8 codes)
- DRG 793 Full Term Neonate with Major Problems (6 of 8 codes)
Other codes that refer to D56
Notes on these codes point to D56.
About the condition
Plain-language background from MedlinePlus (National Library of Medicine), not coding guidance.
Thalassemia
Thalassemias are inherited blood disorders. If you have one, your body makes fewer healthy red blood cells and less hemoglobin. Hemoglobin is a protein that carries oxygen to the body. That leads to anemia. Thalassemias occur most often among people of Italian, Greek, Middle Eastern, Southern Asian, and African descent.
Read more about thalassemia on MedlinePlusCode history
Valid since FY2016, when ICD-10-CM took effect on October 1, 2015. No changes since.