What is ICD-10 code D57.218?

D57.218 is the ICD-10-CM diagnosis code for Sickle-cell/Hb-C disease with crisis with other specified complication. A blood disorder combining sickle cell disease and hemoglobin C disease with a sudden crisis episode involving complications other than those specifically listed. D57.218 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. D57.218 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. D57.218 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. D57.218 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 D57.218?

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 D57.218, V28 maps to Sickle Cell Disorders, Except Sickle Cell Anemia (Hb-SS) and Thalassemia Beta Zero; Beta Thalassemia Major at RAF 0.146 while V24 mapped to Severe Hematological Disorders at RAF 1.372. Both models can still appear in legacy data and in payer-specific lookback periods.

What should coders know when reporting D57.218?

Use this code when documentation describes a specific complication not captured by D57.211-214; clearly document what the complication is Ensure the complication is acute and crisis-related, not a chronic manifestation Because D57.218 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.

2026 ICD-10-CM D57.218: Sickle-cell/Hb-C disease

ICD-10-CM Code View

HCC Buddy Code Card

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Code lookupD57.218Effective 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)

D57.218

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

Sickle-cell/Hb-C disease with crisis with other specified complication

A blood disorder combining sickle cell disease and hemoglobin C disease with a sudden crisis episode involving complications other than those specifically listed.

Buddy Insight

This code captures sickle-cell/Hemoglobin C disease crises with specified complications not classified under acute chest syndrome, splenic sequestration, cerebral vascular involvement, or dactylitis.

CMS-HCC V28

Mapped

HCC 108

Sickle Cell Disorders, Except...

RAF 0.146

CMS-HCC V24

Mapped

HCC 46

Severe Hematological Disorders

RAF 1.372

ACA/HHS

Mapped

HCC 71

HHS-HCC 71

Varies by metal level

ESRD/PACE

Mapped

HCC 46

Severe Hematological Disorders

RAF 0.223

RXHCC

N/A

—

Not risk-adjusted for this model/period.

Not mapped

Code Book Path

Official

D57.2Sickle-cell/Hb-C disease

D57.21Sickle-cell/Hb-C disease with crisis

D57.218Sickle-cell/Hb-C disease with crisis with other specified complication

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for D57.218 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for D57.218 in this effective period.

Related Child Codes

Official

D57.211Sickle-cell/Hb-C disease with acute chest syndrome

D57.212Sickle-cell/Hb-C disease with splenic sequestration

D57.213Sickle-cell/Hb-C disease with cerebral vascular involvement

D57.214Sickle-cell/Hb-C disease with dactylitis

D57.219Sickle-cell/Hb-C disease with crisis, unspecified

Includes

Official

ICD-10-CM does not list Includes notes for D57.218 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for D57.218 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for D57.218 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 D57.218 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

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

The provider should describe the complication type, clinical presentation, supporting diagnostic findings, treatment administered, and clinical outcome.

Record whether the complication results in permanent organ damage.

Specify why the complication does not fit into the D57.211-D57.214 categories.

MEAT Support

HCC Buddy guidance

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

The provider should describe the complication type, clinical presentation, supporting diagnostic findings, treatment administered, and clinical outcome.

Record whether the complication results in permanent organ damage.

Specify why the complication does not fit into the D57.211-D57.214 categories.

Audit Caution

HCC Buddy guidance

Under V28, this maps to HCC 108 (RAF 0.607). The code includes the underlying disease -- do not also assign D57.20 or D57.

Ensure the provider documents the specific complication to justify this code over the unspecified crisis code D57.

Any resulting organ damage (retinopathy, avascular necrosis) should be coded separately to capture full clinical complexity.

Common Mistakes

HCC Buddy guidance

D57.218 vs. D57.219 (Sickle-cell/Hemoglobin C with crisis, unspecified) -- use D57.218 when a specific complication is identified but does not match D57.211-D57.

D57.218 vs. D57.09 (Hemoglobin SS with crisis, other specified complication) -- different sickle cell genotype. D57.218 vs. D57.211-D57.214 -- use the more specific code when the complication matches those categories.

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 D57.218 an HCC code?

Yes. D57.218 (Sickle-cell/Hb-C disease with crisis with other specified complication) maps to Sickle Cell Disorders, Except Sickle Cell Anemia (Hb-SS) and Thalassemia Beta Zero; Beta Thalassemia Major under the CMS-HCC V28 risk adjustment model (and Severe Hematological Disorders under V24), with a community non-dual aged RAF of 0.146. It is billable for payment year 2026.

Coder answer: D57.218 is billable and maps to V28 HCC 108, Sickle Cell Disorders, Except Sickle Cell Anemia (Hb-SS) and Thalassemia Beta Zero; Beta Thalassemia Major. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.

Code: D57.218
Description: Sickle-cell/Hb-C disease with crisis with other specified complication
HCC (V28): HCC 108 — Sickle Cell Disorders, Except Sickle Cell Anemia (Hb-SS) and Thalassemia Beta Zero; Beta Thalassemia Major
RAF: 0.146
Billable: Yes
Payment year: 2026

HCC Category Mapping

V28HCC 108, Sickle Cell Disorders, Except Sickle Cell Anemia (Hb-SS) and Thalassemia Beta Zero; Beta Thalassemia Major

0.146

V24HCC 46, Severe Hematological Disorders

1.372

ESRDHCC 46, Severe Hematological Disorders

0.223

Each model's RAF is its CMS base weight for that model's standard population, so 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 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.

Work D57.218 in the Code Book — tabular path, V28 RAF, and MEAT checklist →

MEAT Criteria for D57.218

For D57.218 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 D57.218 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

D57.218 is the ICD-10-CM diagnosis code for sickle-cell/hb-c disease with crisis with other specified complication. A blood disorder combining sickle cell disease and hemoglobin C disease with a sudden crisis episode involving complications other than those specifically listed. D57.218 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, D57.218 maps to Sickle Cell Disorders, Except Sickle Cell Anemia (Hb-SS) and Thalassemia Beta Zero; Beta Thalassemia Major (HCC 108) with a community, non-dual, aged base RAF weight of 0.146. Under the older CMS-HCC V24 model, D57.218 maps to Severe Hematological Disorders (HCC 46) with a community, non-dual, aged base RAF weight of 1.372. 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 documentation describes a specific complication not captured by D57.211-214; clearly document what the complication is. Because D57.218 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 D57.218 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Use this code when documentation describes a specific complication not captured by D57.211-214; clearly document what the complication is
•Ensure the complication is acute and crisis-related, not a chronic manifestation

Clinical Significance

This code captures sickle-cell/Hemoglobin C disease crises with specified complications not classified under acute chest syndrome, splenic sequestration, cerebral vascular involvement, or dactylitis. Hemoglobin SC-specific complications may include proliferative retinopathy crisis, avascular necrosis exacerbation, priapism, hepatic sequestration, or renal complications. Hemoglobin SC patients are particularly prone to retinal and orthopedic complications compared to other sickle cell genotypes.

Documentation Requirements

✓Documentation must confirm the Hemoglobin SC genotype and identify the specific crisis complication.
✓The provider should describe the complication type, clinical presentation, supporting diagnostic findings, treatment administered, and clinical outcome.
✓Record whether the complication results in permanent organ damage.
✓Specify why the complication does not fit into the D57.211-D57.214 categories.

Use Additional Code

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

Commonly Confused Codes

•D57.218 vs. D57.219 (Sickle-cell/Hemoglobin C with crisis, unspecified) -- use D57.218 when a specific complication is identified but does not match D57.211-D57.
•D57.218 vs. D57.09 (Hemoglobin SS with crisis, other specified complication) -- different sickle cell genotype. D57.218 vs. D57.211-D57.214 -- use the more specific code when the complication matches those categories.