What is ICD-10 code D57.414?

D57.414 is the ICD-10-CM diagnosis code for Sickle-cell thalassemia, unspecified, with dactylitis. It belongs to the ICD-10-CM chapter for diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism (d50-d89). D57.414 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. D57.414 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. D57.414 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. D57.414 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 D57.414?

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 D57.414, V28 maps to Sickle Cell Disorders and Thalassemia at RAF 0.607 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 D57.414?

Verify that the patient has confirmed diagnoses of both sickle-cell disease and thalassemia before assigning this combination code; do not assume one condition based on the other Ensure clinical documentation specifically mentions dactylitis (hand-foot syndrome) as a current manifestation; if dactylitis is not documented, use the appropriate sickle-cell thalassemia code without the dactylitis component Because D57.414 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.

D57.414: Sickle-cell thalassemia, unspecified, with dactylitis — ICD-10 | Sickle Cell Disorders

ICD-10-CM Code View

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Code lookupD57.414Effective 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)

D57.414

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

Sickle-cell thalassemia, unspecified, with dactylitis

This is a blood disorder where a person has both sickle cell disease and thalassemia (two inherited conditions affecting red blood cells), and they are currently experiencing painful swelling in their fingers or toes called dactylitis. Dactylitis is a painful inflammatory condition of the small bones in the hands and feet.

Buddy Insight

CMS-HCC V28

Mapped

HCC 108

Sickle Cell Disorders and Tha...

RAF 0.607

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

Not risk-adjusted for this model/period.

RAF 0

Code Trumping

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Code Book Path

Official

D57.4Sickle-cell thalassemia

D57.41Sickle-cell thalassemia, unspecified, with crisis

D57.414Sickle-cell thalassemia, unspecified, with dactylitis

Inclusion Terms

Official

Sickle-cell thalassemia with (painful) crisis NOS
Sickle-cell thalassemia with (vaso-occlusive) pain NOS

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for D57.414 in this effective period.

Related Child Codes

Official

D57.411Sickle-cell thalassemia, unspecified, with acute chest syndrome

D57.412Sickle-cell thalassemia, unspecified, with splenic sequestration

D57.413Sickle-cell thalassemia, unspecified, with cerebral vascular involvement

D57.418Sickle-cell thalassemia, unspecified, with crisis with other specified complication

D57.419Sickle-cell thalassemia, unspecified, with crisis

Includes

Official

ICD-10-CM does not list Includes notes for D57.414 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for D57.414 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for D57.414 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for D57.414 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for D57.414 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

Documentation must confirm the sickle-cell thalassemia genotype and the specific diagnosis of dactylitis with affected extremities identified.

Query for beta-zero vs.

beta-plus thalassemia specification.

Record pain severity, swelling characteristics, any imaging findings, treatment, and clinical course.

MEAT Support

HCC Buddy guidance

Documentation must confirm the sickle-cell thalassemia genotype and the specific diagnosis of dactylitis with affected extremities identified.

Query for beta-zero vs.

beta-plus thalassemia specification.

Record pain severity, swelling characteristics, any imaging findings, treatment, and clinical course.

Audit Caution

HCC Buddy guidance

Under V28, this maps to HCC 108 (RAF 0.607). Beta-zero specification (D57.434) would yield HCC 107 (RAF 0.727) and RxHCC

Query for thalassemia type specification. The code includes the underlying sickle-cell thalassemia diagnosis. Dactylitis coding is primarily relevant in pediatric encounters.

Common Mistakes

HCC Buddy guidance

D57.414 vs. D57.434 (Beta zero with dactylitis) -

use when beta-zero is confirmed. D57.414 vs. D57.454 (Beta plus with dactylitis) -

use when beta-plus is confirmed. D57.414 vs. D57.04 (Hemoglobin SS with dactylitis) -

different genotype. D57.414 vs. D57.214 (Hemoglobin SC with dactylitis) -

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 D57.414 an HCC code?

Yes. D57.414 maps to Sickle Cell Disorders and Thalassemia under the CMS-HCC V28 risk adjustment model (and Severe Hematological Disorders under V24).

HCC Category Mapping

V28HCC 108, Sickle Cell Disorders and Thalassemia

0.607

V24HCC 46, Severe Hematological Disorders

0.666

ESRDHCC 46, Severe Hematological Disorders

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 D57.414

For D57.414to 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 D57.414 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

D57.414 is the ICD-10-CM diagnosis code for sickle-cell thalassemia, unspecified, with dactylitis. This is a blood disorder where a person has both sickle cell disease and thalassemia (two inherited conditions affecting red blood cells), and they are currently experiencing painful swelling in their fingers or toes called dactylitis. Dactylitis is a painful inflammatory condition of the small bones in the hands and feet. D57.414 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, D57.414 maps to Sickle Cell Disorders and Thalassemia (HCC 108) with a community, non-dual, aged base RAF weight of 0.607. Under the older CMS-HCC V24 model, D57.414 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.

Verify that the patient has confirmed diagnoses of both sickle-cell disease and thalassemia before assigning this combination code; do not assume one condition based on the other. Because D57.414 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 D57.414 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Verify that the patient has confirmed diagnoses of both sickle-cell disease and thalassemia before assigning this combination code; do not assume one condition based on the other
•Ensure clinical documentation specifically mentions dactylitis (hand-foot syndrome) as a current manifestation; if dactylitis is not documented, use the appropriate sickle-cell thalassemia code without the dactylitis component

Clinical Significance

Dactylitis in unspecified sickle-cell thalassemia represents painful vaso-occlusive swelling of the hands and feet in patients with combined sickle cell and thalassemia genes where the specific thalassemia type is not documented. As with other sickle cell genotypes, dactylitis is primarily seen in young children and may be the first clinical manifestation leading to sickle-cell thalassemia diagnosis.

Documentation Requirements

✓Documentation must confirm the sickle-cell thalassemia genotype and the specific diagnosis of dactylitis with affected extremities identified.
✓Query for beta-zero vs.
✓beta-plus thalassemia specification.
✓Record pain severity, swelling characteristics, any imaging findings, treatment, and clinical course.
✓Document the patient's age and whether this presentation led to the initial diagnosis.

Commonly Confused Codes

•D57.414 vs. D57.434 (Beta zero with dactylitis) -
•use when beta-zero is confirmed. D57.414 vs. D57.454 (Beta plus with dactylitis) -
•use when beta-plus is confirmed. D57.414 vs. D57.04 (Hemoglobin SS with dactylitis) -
•different genotype. D57.414 vs. D57.214 (Hemoglobin SC with dactylitis) -
•different genotype.