What is ICD-10 code D57.418?

D57.418 is the ICD-10-CM diagnosis code for Sickle-cell thalassemia, unspecified, with crisis with other specified complication. A combination blood disorder mixing sickle-cell disease and thalassemia that causes a crisis with additional complications beyond the typical sickle-cell crisis symptoms. D57.418 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. D57.418 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. D57.418 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. D57.418 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 D57.418 map to under V28?

D57.418 maps to CMS-HCC V28 HCC 108 (Sickle Cell Disorders, Except Sickle Cell Anemia (Hb-SS) and Thalassemia Beta Zero; Beta Thalassemia Major). The category numbers, labels, and conditions come from the CMS-HCC V28 model file for payment year 2026.

2026 ICD-10-CM D57.418: Sickle-cell thalassemia

D57.418 maps to CMS-HCC V28 108. A source-labeled RAF reference is available. Confirm the documented diagnosis and applicable coding requirements. MEAT criteria · RAF Calculator · HCC coding software

ICD-10-CM Code View

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Code lookupD57.418

Effective 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)

D57.418

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

Sickle-cell thalassemia, unspecified, with crisis with other specified complication

A combination blood disorder mixing sickle-cell disease and thalassemia that causes a crisis with additional complications beyond the typical sickle-cell crisis symptoms.

Buddy Insight

Overview Risk Models Code Book Documentation Audit Notes Edition comparison

CMS-HCC V28

Mapped

HCC 108

Sickle Cell Disorders, Except...

Code-level coefficient reference

CMS-HCC V24

Historical

Not used for standard CY2026 Medicare Advantage payment. Select a historical period to review V24.

Not used for CY2026 payment

ACA/HHS

Mapped

HCC 071

HHS-HCC 071 adult, RAF varies...

Code-level coefficient reference

ESRD/PACE

Mapped

HCC 46

Severe Hematological Disorders

Code-level coefficient reference

RXHCC

N/A

—

Not risk-adjusted for this model/period.

Not mapped

Code Book Path

Official

D57.4Sickle-cell thalassemia D57.41Sickle-cell thalassemia, unspecified, with crisis D57.418Sickle-cell thalassemia, unspecified, with crisis with other specified complication

Inclusion Terms

Official

Sickle-cell beta thalassemiaInherited from D57.4, D57.41
Thalassemia Hb-S diseaseInherited from D57.4, D57.41
Sickle-cell thalassemia with (painful) crisis NOSInherited from D57.4, D57.41
Sickle-cell thalassemia with (vaso-occlusive) pain NOSInherited from D57.4, D57.41

Excludes 2

Official

autoimmune disease (systemic) NOS (M35.9)Inherited from D50-D89
certain conditions originating in the perinatal period (P00-P96)Inherited from D50-D89
complications of pregnancy, childbirth and the puerperium (O00-O9A)Inherited from D50-D89
congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)Inherited from D50-D89
endocrine, nutritional and metabolic diseases (E00-E88)Inherited from D50-D89
human immunodeficiency virus [HIV] disease (B20)Inherited from D50-D89
injury, poisoning and certain other consequences of external causes (S00-T88)Inherited from D50-D89
neoplasms (C00-D49)Inherited from D50-D89
symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)Inherited from D50-D89

Related 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 D57.414Sickle-cell thalassemia, unspecified, with dactylitis D57.419Sickle-cell thalassemia, unspecified, with crisis

Includes

Official

No Includes notes are included in this display for D57.418. Check the code and parent instructions in the Code Book.

Excludes 1

Official

other hemoglobinopathies (D58.-)Inherited from D57

Code First

Official

No Code First sequencing instructions are included in this display for D57.418. Check the code and parent instructions in the Code Book.

Use Additional

Official

code to identify complications, such as:
cholelithiasis (K80.-)
priapism (N48.32)
code for any associated fever (R50.81)Inherited from D57

Code Also

Official

No Code Also instructions are included in this display for D57.418. Check the code and parent instructions in the Code Book.

Buddy Documentation Tip

HCC Buddy guidance

Documentation must confirm the sickle-cell thalassemia genotype, identify the specific crisis complication, and query for beta-zero vs.

beta-plus specification.

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

Document why the complication does not fit D57.411-D57.414 categories.

MEAT Support

HCC Buddy guidance

Documentation must confirm the sickle-cell thalassemia genotype, identify the specific crisis complication, and query for beta-zero vs.

beta-plus specification.

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

Document why the complication does not fit D57.411-D57.414 categories.

Audit Caution

HCC Buddy guidance

Two documentation queries should be pursued: thalassemia type specification and crisis complication specification.

Any organ damage resulting from the crisis should be coded separately.

Common Mistakes

HCC Buddy guidance

D57.418 vs. D57.438 (Beta zero with other specified complication) -

use when beta-zero is confirmed. D57.418 vs. D57.458 (Beta plus with other specified complication) -

use when beta-plus is confirmed. D57.418 vs. D57.419 (Sickle-cell thalassemia with crisis, unspecified) -

use D57.418 when a specific complication is identified. D57.418 vs. D57.09 (Hemoglobin SS with other specified complication) -

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 D57.418 an HCC code?

Yes. D57.418 (Sickle-cell thalassemia, unspecified, with crisis with other specified complication) maps to HCC 108, Sickle Cell Disorders, Except Sickle Cell Anemia (Hb-SS) and Thalassemia Beta Zero; Beta Thalassemia Major under the CMS-HCC V28 risk adjustment model, with a source-labeled community non-dual aged reference coefficient of 0.146. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes. It is billable for payment year 2026.

Coder answer: D57.418 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: D57.418
Description: Sickle-cell thalassemia, unspecified, 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 reference coefficient: 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

ESRDHCC 46, Severe Hematological Disorders

Not separately weighted

These are source-labeled model coefficients, not member totals. A category may still be removed by hierarchy or model cleanup rules. 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 context, hierarchy and cleanup rules, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains available for historical review.

Work D57.418 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT review for D57.418

For D57.418, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule.

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

Coder workflow notes

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What This Code Means

D57.418 is the ICD-10-CM diagnosis code for sickle-cell thalassemia, unspecified, with crisis with other specified complication. A combination blood disorder mixing sickle-cell disease and thalassemia that causes a crisis with additional complications beyond the typical sickle-cell crisis symptoms. D57.418 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, D57.418 maps to Sickle Cell Disorders, Except Sickle Cell Anemia (Hb-SS) and Thalassemia Beta Zero; Beta Thalassemia Major (HCC 108) with a source-labeled community, non-dual, aged reference coefficient of 0.146. No V24 mapping is shown for D57.418; use the applicable model and payment year when reviewing the V28 mapping. For CY2026 non-PACE Medicare Advantage, CMS uses 100% of the 2024 CMS-HCC model (V28). PACE uses a separate model blend. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes.

Ensure documentation specifies the exact complication beyond standard crisis (e.g., infection, organ damage) to justify the 'other specified' designation. For D57.418, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule. 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, source-labeled coefficient references, and MEAT documentation criteria for D57.418 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Ensure documentation specifies the exact complication beyond standard crisis (e.g., infection, organ damage) to justify the 'other specified' designation
•Verify the thalassemia type is unspecified before assigning this code; if beta-zero or beta-plus is documented, use the more specific codes D57.43x or D57.45x

Clinical Significance

This code captures sickle-cell thalassemia (unspecified type) crises with specified complications not classified under acute chest syndrome, splenic sequestration, cerebral vascular involvement, or dactylitis. These may include priapism, hepatic sequestration, aplastic crisis, renal crisis, or other organ-specific vaso-occlusive events in patients whose thalassemia subtype (beta-zero vs. beta-plus) is undocumented.

Documentation Requirements

✓Documentation must confirm the sickle-cell thalassemia genotype, identify the specific crisis complication, and query for beta-zero vs.
✓beta-plus specification.
✓The provider should describe the complication type, clinical presentation, diagnostic findings, treatment, and outcome.
✓Document why the complication does not fit D57.411-D57.414 categories.

Use Additional Code

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

Commonly Confused Codes

•D57.418 vs. D57.438 (Beta zero with other specified complication) -
•use when beta-zero is confirmed. D57.418 vs. D57.458 (Beta plus with other specified complication) -
•use when beta-plus is confirmed. D57.418 vs. D57.419 (Sickle-cell thalassemia with crisis, unspecified) -
•use D57.418 when a specific complication is identified. D57.418 vs. D57.09 (Hemoglobin SS with other specified complication) -
•different genotype.