D57.214

HCC Category Mapping

What This Code Means

A blood disorder combining sickle cell disease and hemoglobin C disease that causes severe pain and swelling in the hands and feet due to blocked blood vessels.

Coding Tips

• •Dactylitis (hand-foot syndrome) is common in sickle cell disease; ensure documentation specifies which extremities are affected
• •Verify this represents acute dactylitis crisis rather than chronic pain management

Clinical Significance

Dactylitis in sickle-cell/Hemoglobin C disease represents painful swelling of the hands and feet from vaso-occlusion in the small bones, though it is less common in Hemoglobin SC than in Hemoglobin SS disease. In Hemoglobin SC patients, dactylitis may present later in childhood and with milder symptoms compared to Hemoglobin SS. It remains an important early sign of sickle cell disease that may lead to initial diagnosis.

Documentation Requirements

• ✓Documentation must confirm the Hemoglobin SC genotype and the specific diagnosis of dactylitis with description of affected extremities, swelling, and tenderness.
• ✓Record pain severity and management, any imaging findings showing bony changes, and the clinical course.
• ✓Note the patient's age at presentation and whether this led to the initial sickle cell disease diagnosis.

Commonly Confused Codes