What is ICD-10 code D55.8?

D55.8 is the ICD-10-CM diagnosis code for Other anemias due to enzyme disorders. A type of anemia caused by various enzyme disorders not specifically classified elsewhere. These enzyme deficiencies affect red blood cell function and survival. D55.8 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. D55.8 is part of the FY2026 ICD-10-CM code set published by the CMS National Center for Health Statistics and used on Medicare, Medicaid, and commercial claims in the United States.

Yes. D55.8 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. D55.8 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

Which HCC does D55.8 map to under V28?

D55.8 has no payable CMS-HCC V28 mapping in the final FY2026 CMS file.

What RAF reference is published for D55.8?

D55.8 has no V28 reference coefficient because the final FY2026 source verifies no payable V28 mapping.

What is the V28 vs V24 difference for D55.8?

D55.8 has verified no payable V28 mapping in the final FY2026 source. Select a historical effective period before making any V24 comparison.

What documentation supports D55.8?

Use this code for enzyme-related anemias that don't fit into more specific categories Document the specific enzyme disorder in the medical record even if using this catch-all code D55.8 is not a CMS-HCC V28 payment code in the verified current source, so MEAT is not the payment hook. Documentation still has to support the diagnosis if you report it.

2026 ICD-10-CM D55.8: Other anemias due to enzyme disorders

D55.8 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · HCC Buddy coding tools

ICD-10-CM Code View

HCC Buddy Code Card

Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.

Code lookupD55.8Effective periodFY2026 Apr Update (Apr 1-Sep 30)

FY 2026 Apr update / Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism (D50-D89) / Hemolytic anemias (D55-D59)

D55.8

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Other anemias due to enzyme disorders

A type of anemia caused by various enzyme disorders not specifically classified elsewhere. These enzyme deficiencies affect red blood cell function and survival.

Buddy Insight

This code captures hemolytic anemias resulting from enzyme disorders that do not fit into the more specific subcategories of glycolytic, glutathione, or nucleotide metabolism defects.

CMS-HCC V28

N/A

—

Not risk-adjusted for this model/period.

Not mapped

CMS-HCC V24

Historical

Not used for standard CY2026 Medicare Advantage payment. Select a historical period to review V24.

Not used for CY2026 payment

ACA/HHS

N/A

—

Not risk-adjusted for this model/period.

Not mapped

ESRD/PACE

Mapped

HCC 48

Coagulation Defects and Other...

Code-level coefficient reference

RXHCC

N/A

—

Not risk-adjusted for this model/period.

Not mapped

Code Book Path

Official

D55Anemia due to enzyme disorders

D55.8Other anemias due to enzyme disorders

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for D55.8 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for D55.8 in this effective period.

Related Child Codes

Official

D55.0Anemia due to glucose-6-phosphate dehydrogenase [G6PD] deficiency

D55.1Anemia due to other disorders of glutathione metabolism

D55.2Anemia due to disorders of glycolytic enzymes

D55.3Anemia due to disorders of nucleotide metabolism

D55.9Anemia due to enzyme disorder, unspecified

Includes

Official

ICD-10-CM does not list Includes notes for D55.8 in this effective period.

Excludes 1

Official

drug-induced enzyme deficiency anemia (D59.2)

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for D55.8 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for D55.8 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for D55.8 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

Documentation should describe the enzyme disorder as specifically as possible, including any enzyme assay results, genetic testing, or pathologic findings.

Record hemolysis markers, hemoglobin levels, transfusion history, and complications such as cholelithiasis or iron overload.

The provider should document why a more specific D55 subcategory code does not apply.

MEAT Support

HCC Buddy guidance

Documentation should describe the enzyme disorder as specifically as possible, including any enzyme assay results, genetic testing, or pathologic findings.

Record hemolysis markers, hemoglobin levels, transfusion history, and complications such as cholelithiasis or iron overload.

The provider should document why a more specific D55 subcategory code does not apply.

Audit Caution

HCC Buddy guidance

This code has no V28 HCC mapping. Do not use D55.8 as a convenience code when more specific classification is possible within D55.0-D55.3 or D55.

Query the provider for additional specificity before defaulting to this category. Ensure the condition is documented as enzyme-related and not a membrane disorder (D58) or acquired hemolytic anemia (D59).

Common Mistakes

HCC Buddy guidance

D55.8 vs. D55.9 (Anemia due to enzyme disorder, unspecified) -

use D55.8 when the enzyme disorder is identified but does not fit specific subcategories, vs. D55.9 when the enzyme disorder is completely unidentified. D55.8 vs. D58.8 (Other specified hereditary hemolytic anemias) -

D58.8 covers non-enzyme hereditary causes like membrane disorders. D55.8 vs. D55.0-D55.3 -

use more specific codes when the metabolic pathway is clearly identified.

Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →

Is D55.8 an HCC code?

D55.8 is not in the CMS-HCC V28 or V24 community payment model. D55.8 has a separate mapping under the CMS-HCC ESRD model (HCC 48 (Coagulation Defects and Other Specified Hematological Disorders)); the applicable result needs member context.

Code: D55.8
Description: Other anemias due to enzyme disorders
HCC (V28): No CMS-HCC V28 mapping
RAF reference coefficient: —
Billable: Yes
Payment year: 2026

HCC Category Mapping

ESRDHCC 48, Coagulation Defects and Other Specified Hematological Disorders

Not separately weighted

These are source-labeled model coefficients, not member totals. A category may still be removed by hierarchy or model cleanup rules. Weights are not directly comparable across models: CMS-HCC V28 and V24 use Community, Non-Dual, Aged; ESRD uses the dialysis continuing-enrollee model; RxHCC is the Part D continuing-enrollee, non-low-income, aged weight (a larger scale than CMS-HCC). ACA/HHS has no single weight — it varies by metal level. Actual per-patient RAF contribution depends on member context, hierarchy and cleanup rules, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains available for historical review.

Work D55.8 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT Criteria for D55.8

For D55.8 to count as a valid HCC diagnosis in a given encounter, the provider's documentation must show MEAT: Monitor, Evaluate, Assess, or Treat. A diagnosis from a prior year does not carry forward automatically, it has to be re-documented and supported each calendar year.

MMonitor: signs, symptoms, disease progression, or lab trending documented in the note
EEvaluate: test results, medication response, or physical findings reviewed by the provider
AAssess: explicit mention in the assessment or plan with acknowledgment of status
TTreat: medication, referral, procedure, therapy, or counseling tied to the diagnosis

Only one of M/E/A/T is required to support the code, but the documentation must be specific enough to show that the provider actually addressed D55.8 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

D55.8 is the ICD-10-CM diagnosis code for other anemias due to enzyme disorders. A type of anemia caused by various enzyme disorders not specifically classified elsewhere. These enzyme deficiencies affect red blood cell function and survival. D55.8 sits in the ICD-10-CM chapter for diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism (d50-d89), within the section covering hemolytic anemias (d55-d59).

D55.8 has no mapping under the CMS-HCC V28 or V24 community payment models. D55.8 has a separate mapping under the CMS-HCC ESRD model (HCC 48 (Coagulation Defects and Other Specified Hematological Disorders)); the applicable result needs member context. Do not assign V28 risk adjustment value from this page; verify the applicable model and payment year before using this code for risk adjustment.

Use this code for enzyme-related anemias that don't fit into more specific categories.

HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for D55.8 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Use this code for enzyme-related anemias that don't fit into more specific categories
•Document the specific enzyme disorder in the medical record even if using this catch-all code

Clinical Significance

This code captures hemolytic anemias resulting from enzyme disorders that do not fit into the more specific subcategories of glycolytic, glutathione, or nucleotide metabolism defects. These may include disorders of the hexose monophosphate shunt (other than Glucose-6-phosphate dehydrogenase deficiency) or other rare enzymopathies affecting red blood cell viability. While individually rare, they collectively represent important causes of chronic hemolysis that require ongoing clinical management.

Documentation Requirements

✓Documentation should describe the enzyme disorder as specifically as possible, including any enzyme assay results, genetic testing, or pathologic findings.
✓Record hemolysis markers, hemoglobin levels, transfusion history, and complications such as cholelithiasis or iron overload.
✓The provider should document why a more specific D55 subcategory code does not apply.

Commonly Confused Codes

•D55.8 vs. D55.9 (Anemia due to enzyme disorder, unspecified) -
•use D55.8 when the enzyme disorder is identified but does not fit specific subcategories, vs. D55.9 when the enzyme disorder is completely unidentified. D55.8 vs. D58.8 (Other specified hereditary hemolytic anemias) -
•D58.8 covers non-enzyme hereditary causes like membrane disorders. D55.8 vs. D55.0-D55.3 -
•use more specific codes when the metabolic pathway is clearly identified.