What is ICD-10 code D57.09?

D57.09 is the ICD-10-CM diagnosis code for Hb-SS disease with crisis with other specified complication. Sickle cell disease with an acute crisis and a complication other than splenic sequestration, stroke, or hand-foot syndrome, such as acute chest syndrome or kidney problems. D57.09 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. D57.09 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. D57.09 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. D57.09 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.

What is the V28 vs V24 difference for D57.09?

CMS phased in the V28 risk adjustment model over payment years 2024 (33%), 2025 (67%), and 2026 (100%), replacing V24. V28 consolidates HCC categories, removes some lower-acuity conditions, and recalibrates RAF weights across the entire model. For D57.09, V28 maps to Sickle Cell Anemia (Hb-SS) and Thalassemia Beta Zero at RAF 0.727 while V24 mapped to Severe Hematological Disorders at RAF 0.666. Both models can still appear in legacy data and in payer-specific lookback periods.

What should coders know when reporting D57.09?

Use this code when crisis is documented with complications not covered by D57.02, D57.03, or D57.04 Clearly document the specific complication (acute chest syndrome, renal infarction, etc.) in the medical record Because D57.09 maps to a payment HCC, the documentation must also satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's risk adjustment score.

D57.09 ICD-10 Code: Hb-SS disease with crisis

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 lookupD57.09Effective 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)

D57.09

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

Hb-SS disease with crisis with other specified complication

Sickle cell disease with an acute crisis and a complication other than splenic sequestration, stroke, or hand-foot syndrome, such as acute chest syndrome or kidney problems.

Buddy Insight

CMS-HCC V28

Mapped

HCC 107

Sickle Cell Anemia (Hb-SS) an...

RAF 0.727

CMS-HCC V24

Mapped

HCC 46

Severe Hematological Disorders

RAF 0.666

ACA/HHS

Not risk-adjusted for this model/period.

RAF 0

ESRD/PACE

Mapped

HCC 46

Severe Hematological Disorders

RAF 0.0

RXHCC

Mapped

HCC 95

Sickle Cell Anemia (Hb-SS) an...

RAF 0.0

Code Trumping

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Code Book Path

Official

D57Sickle-cell disorders

D57.0Hb-SS disease with crisis

D57.09Hb-SS disease with crisis with other specified complication

Inclusion Terms

Official

Sickle-cell disease with crisis
Hb-SS disease with (vaso-occlusive) pain

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for D57.09 in this effective period.

Related Child Codes

Official

D57.00Hb-SS disease with crisis, unspecified

D57.01Hb-SS disease with acute chest syndrome

D57.02Hb-SS disease with splenic sequestration

D57.03Hb-SS disease with cerebral vascular involvement

D57.04Hb-SS disease with dactylitis

Includes

Official

ICD-10-CM does not list Includes notes for D57.09 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for D57.09 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for D57.09 in this effective period.

Use Additional

Official

code to identify complications, such as:
cholelithiasis (K80.-)
priapism (N48.32)

Code Also

Official

ICD-10-CM does not list Code Also instructions for D57.09 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

Documentation must confirm Hemoglobin SS genotype and identify the specific crisis complication present.

The provider should clearly describe the complication type (e.g., priapism, hepatic sequestration, aplastic crisis, acute kidney injury), supporting clinical findings, laboratory results, imaging if applicable, and treatment administered.

Record the clinical course and any resulting organ damage.

MEAT Support

HCC Buddy guidance

Documentation must confirm Hemoglobin SS genotype and identify the specific crisis complication present.

Record the clinical course and any resulting organ damage.

Audit Caution

HCC Buddy guidance

Under V28, this maps to HCC 107 (RAF 0.727). Ensure the provider documents the specific complication rather than just 'crisis' to justify this code over D57.

The code includes sickle cell disease -- do not also assign D57.

If the complication leads to organ damage (e.g., chronic kidney disease from renal crisis), code those conditions separately for full clinical picture and potential additional HCC capture.

Common Mistakes

HCC Buddy guidance

D57.09 vs. D57.00 (Hemoglobin SS with crisis, unspecified) -- use D57.09 when a specific complication is documented but does not match D57.01-D57.

D57.09 vs. D57.01 (Acute chest syndrome) or D57.03 (Cerebral vascular involvement) -- use the more specific crisis code when the complication matches those categories. D57.09 vs. D57.218 (Sickle-cell/Hemoglobin C with other specified complication) -- different sickle cell genotype.

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.

Is D57.09 an HCC code?

Yes. D57.09 maps to Sickle Cell Anemia (Hb-SS) and Thalassemia Beta Zero under the CMS-HCC V28 risk adjustment model (and Severe Hematological Disorders under V24).

HCC Category Mapping

V28HCC 107, Sickle Cell Anemia (Hb-SS) and Thalassemia Beta Zero

0.727

V24HCC 46, Severe Hematological Disorders

0.666

ESRDHCC 46, Severe Hematological Disorders

0.000

RxHCCHCC 95, Sickle Cell Anemia (Hb-SS) and Thalassemia Beta Zero

0.000

RAF weights shown are the community, non-dual, aged base weights from the CMS risk adjustment model file. Actual per-patient RAF contribution depends on member segment, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains in use during the transition and for historical data.

MEAT Criteria for D57.09

For D57.09to 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 D57.09 during that encounter, not just copy-forwarded from a problem list.

What This Code Means

D57.09 is the ICD-10-CM diagnosis code for hb-ss disease with crisis with other specified complication. Sickle cell disease with an acute crisis and a complication other than splenic sequestration, stroke, or hand-foot syndrome, such as acute chest syndrome or kidney problems. D57.09 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).

Under the CMS-HCC V28 risk adjustment model, D57.09 maps to Sickle Cell Anemia (Hb-SS) and Thalassemia Beta Zero (HCC 107) with a community, non-dual, aged base RAF weight of 0.727. Under the older CMS-HCC V24 model, D57.09 maps to Severe Hematological Disorders (HCC 46) with a community, non-dual, aged base RAF weight of 0.666. V28 is the CMS-HCC risk adjustment model that reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition.

Use this code when crisis is documented with complications not covered by D57.02, D57.03, or D57.04. Because D57.09 maps to a payment HCC, the provider's documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's Medicare Advantage risk adjustment score. When documentation is ambiguous, coders should issue a provider query rather than assume the highest-specificity variant.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for D57.09 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Use this code when crisis is documented with complications not covered by D57.02, D57.03, or D57.04
•Clearly document the specific complication (acute chest syndrome, renal infarction, etc.) in the medical record

Clinical Significance

This code captures Hemoglobin SS disease crises with specified complications that do not fall into the acute chest syndrome, splenic sequestration, cerebral vascular involvement, or dactylitis categories. These may include priapism, hepatic sequestration, aplastic crisis (often triggered by parvovirus B19), renal complications, or other organ-specific vaso-occlusive events. Each of these complications carries significant morbidity and may require specialized management.

Documentation Requirements

✓Documentation must confirm Hemoglobin SS genotype and identify the specific crisis complication present.
✓The provider should clearly describe the complication type (e.g., priapism, hepatic sequestration, aplastic crisis, acute kidney injury), supporting clinical findings, laboratory results, imaging if applicable, and treatment administered.
✓Record the clinical course and any resulting organ damage.

Use Additional Code

code to identify complications, such as:
cholelithiasis (K80.-)
priapism (N48.32)

Commonly Confused Codes

•D57.09 vs. D57.00 (Hemoglobin SS with crisis, unspecified) -- use D57.09 when a specific complication is documented but does not match D57.01-D57.
•D57.09 vs. D57.01 (Acute chest syndrome) or D57.03 (Cerebral vascular involvement) -- use the more specific crisis code when the complication matches those categories. D57.09 vs. D57.218 (Sickle-cell/Hemoglobin C with other specified complication) -- different sickle cell genotype.