What is ICD-10 code D57.3?

D57.3 is the ICD-10-CM diagnosis code for Sickle-cell trait. A genetic condition where a person carries one sickle cell gene and one normal gene, making them a carrier of sickle cell disease but typically without symptoms. D57.3 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. D57.3 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. D57.3 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. D57.3 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 D57.3 map to under V28?

D57.3 does not map to a CMS-HCC V28 payment category. Check the current CMS-HCC V28 model file for payment year 2026 rather than an older V24 tip sheet.

What does D57.3 pay in RAF?

D57.3 has no separately stated V28 community RAF weight. If it is not a V28 payment HCC, it adds nothing to a community RAF score.

What is the V28 vs V24 difference for D57.3?

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. D57.3 was a payment HCC under V24 (Coagulation Defects and Other Specified Hematological Disorders) but the V28 recalibration removed it from the risk adjustment model. Both models can still appear in legacy data and in payer-specific lookback periods.

What documentation supports D57.3?

Sickle cell trait is a carrier state, not the disease itself; patients are usually asymptomatic and do not require crisis management Do not confuse with sickle cell disease codes; trait carriers have different clinical implications and prognosis Because D57.3 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. See the MEAT criteria checklist at /meat-criteria for what Monitor, Evaluate, Assess, or Treat looks like in a note. MEAT is generic documentation evidence, not a payer-specific rule.

2026 ICD-10-CM D57.3: Sickle-cell trait

D57.3 is not a CMS-HCC payment code. MEAT criteria · RAF calculator · HCC Buddy coding tools

ICD-10-CM Code View

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Code lookupD57.3Effective 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)

D57.3

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

Sickle-cell trait

A genetic condition where a person carries one sickle cell gene and one normal gene, making them a carrier of sickle cell disease but typically without symptoms.

Buddy Insight

Sickle cell trait (Hemoglobin AS) is the heterozygous carrier state where one normal hemoglobin gene and one sickle hemoglobin gene are inherited.

CMS-HCC V28

N/A

—

Not risk-adjusted for this model/period.

Not mapped

CMS-HCC V24

Mapped

HCC 48

Coagulation Defects and Other...

RAF 0.192

ACA/HHS

N/A

—

Not risk-adjusted for this model/period.

Not mapped

ESRD/PACE

Mapped

HCC 48

Coagulation Defects and Other...

RAF 0.063

RXHCC

N/A

—

Not risk-adjusted for this model/period.

Not mapped

Code Book Path

Official

D57Sickle-cell disorders

D57.3Sickle-cell trait

Inclusion Terms

Official

Hb-S trait
Heterozygous hemoglobin S

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for D57.3 in this effective period.

Related Child Codes

Official

D57.0Hb-SS disease with crisis

D57.1Sickle-cell disease without crisis

D57.2Sickle-cell/Hb-C disease

D57.4Sickle-cell thalassemia

D57.8Other sickle-cell disorders

Includes

Official

ICD-10-CM does not list Includes notes for D57.3 in this effective period.

Excludes 1

Official

other hemoglobinopathies (D58.-)

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for D57.3 in this effective period.

Use Additional

Official

code for any associated fever (R50.81)

Code Also

Official

ICD-10-CM does not list Code Also instructions for D57.3 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

Documentation should confirm sickle cell trait through hemoglobin electrophoresis showing Hemoglobin AS pattern, typically with 35-45% Hemoglobin S.

Record any associated complications if present, and note the condition's relevance for genetic counseling, particularly regarding family planning.

Document that this is the carrier state, not sickle cell disease.

Note any military service, athletic, or high-altitude activity counseling provided.

MEAT Support

HCC Buddy guidance

Documentation should confirm sickle cell trait through hemoglobin electrophoresis showing Hemoglobin AS pattern, typically with 35-45% Hemoglobin S.

Record any associated complications if present, and note the condition's relevance for genetic counseling, particularly regarding family planning.

Document that this is the carrier state, not sickle cell disease.

Note any military service, athletic, or high-altitude activity counseling provided.

Audit Caution

HCC Buddy guidance

This code has no V28 HCC mapping, reflecting its generally benign nature. Under V24, it maps to HCC 48 (RAF 0.209), not the higher-value HCC 46 used for sickle cell disease. Never code sickle cell trait as sickle cell disease -

they are clinically and genetically distinct conditions. Sickle cell trait should not generate crisis codes. Ensure documentation clearly states 'trait' or 'carrier' to avoid miscoding as active disease.

Common Mistakes

HCC Buddy guidance

D57.3 vs. D57.1 (Sickle-cell disease without crisis) -

sickle cell trait is the carrier state (Hemoglobin AS), fundamentally different from sickle cell disease (Hemoglobin SS). D57.3 vs. D57.20 (Sickle-cell/Hemoglobin C without crisis) -

Hemoglobin SC is a disease state, not a carrier state. D57.3 vs. Z77.098 (Contact with and exposure to other hazardous substances) -

do not confuse with exposure codes.

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 D57.3 an HCC code?

Yes. D57.3 maps to Coagulation Defects and Other Specified Hematological Disorders under the V24 model but is not retained in V28.

Code: D57.3
Description: Sickle-cell trait
HCC (V28): No CMS-HCC V28 mapping
RAF: —
Billable: Yes
Payment year: 2026

HCC Category Mapping

V24HCC 48, Coagulation Defects and Other Specified Hematological Disorders

0.192

ESRDHCC 48, Coagulation Defects and Other Specified Hematological Disorders

0.063

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 D57.3 in the Code Book — tabular path, V28 RAF, and MEAT checklist →

MEAT Criteria for D57.3

For D57.3 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 D57.3 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

D57.3 is the ICD-10-CM diagnosis code for sickle-cell trait. A genetic condition where a person carries one sickle cell gene and one normal gene, making them a carrier of sickle cell disease but typically without symptoms. D57.3 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 older CMS-HCC V24 model, D57.3 maps to Coagulation Defects and Other Specified Hematological Disorders (HCC 48) with a community, non-dual, aged base RAF weight of 0.192. 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.

Sickle cell trait is a carrier state, not the disease itself; patients are usually asymptomatic and do not require crisis management. Because D57.3 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 D57.3 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Sickle cell trait is a carrier state, not the disease itself; patients are usually asymptomatic and do not require crisis management
•Do not confuse with sickle cell disease codes; trait carriers have different clinical implications and prognosis

Clinical Significance

Sickle cell trait (Hemoglobin AS) is the heterozygous carrier state where one normal hemoglobin gene and one sickle hemoglobin gene are inherited. It is generally considered a benign condition affecting approximately 8% of African Americans, though rare complications can occur under extreme conditions including exertional rhabdomyolysis, renal medullary carcinoma, splenic infarction at high altitude, and exercise-related sudden death. It is fundamentally different from sickle cell disease.

Documentation Requirements

✓Documentation should confirm sickle cell trait through hemoglobin electrophoresis showing Hemoglobin AS pattern, typically with 35-45% Hemoglobin S.
✓Record any associated complications if present, and note the condition's relevance for genetic counseling, particularly regarding family planning.
✓Document that this is the carrier state, not sickle cell disease.
✓Note any military service, athletic, or high-altitude activity counseling provided.

Commonly Confused Codes

•D57.3 vs. D57.1 (Sickle-cell disease without crisis) -
•sickle cell trait is the carrier state (Hemoglobin AS), fundamentally different from sickle cell disease (Hemoglobin SS). D57.3 vs. D57.20 (Sickle-cell/Hemoglobin C without crisis) -
•Hemoglobin SC is a disease state, not a carrier state. D57.3 vs. Z77.098 (Contact with and exposure to other hazardous substances) -
•do not confuse with exposure codes.