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D56 ICD-10-CM Code: Thalassemia

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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)

D56

Header CodeICD-10-CMOfficial ICD-10-CMCodebook guidance

Thalassemia

Thalassemia

CMS-HCC V28

0

0

RAF 0

CMS-HCC V24

0

0

RAF 0

ACA/HHS

0

0

RAF 0

ESRD/PACE

0

0

RAF 0

RXHCC

0

0

RAF 0

Code Trumping

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Code Book Path

Official
D5Hemolytic anemias (D55-D59)
D56Thalassemia

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for D56 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for D56 in this effective period.

Related Child Codes

Official
D56.0Alpha thalassemia
D56.1Beta thalassemia
D56.2Delta-beta thalassemia
D56.3Thalassemia minor
D56.4Hereditary persistence of fetal hemoglobin [HPFH]

Includes

Official

ICD-10-CM does not list Includes notes for D56 in this effective period.

Excludes 1

Official
  • sickle-cell thalassemia (D57.4-)

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for D56 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for D56 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for D56 in this effective period.

Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.

What This Code Means

D56 is the ICD-10-CM diagnosis code for thalassemia. D56 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).

Header codes like D56 cannot be reported on claims directly, they organize child codes that share clinical context but the actual diagnosis must be coded to the highest level of specificity supported by the documentation. Coders should look at D56's child codes and select the one that matches the patient's documented presentation, since payers reject header codes submitted as the primary diagnosis. For risk adjustment workflows, header codes never contribute to a Medicare Advantage member's RAF score on their own; only billable child codes that happen to map to a payment HCC affect risk-adjusted plan payments.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for D56 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Excludes 1, Do NOT code together

  • sickle-cell thalassemia (D57.4-)

Child Codes

Code Hierarchy

D56Thalassemia
D56Thalassemia

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