What is ICD-10 code D57.432?

D57.432 is the ICD-10-CM diagnosis code for Sickle-cell thalassemia beta zero with splenic sequestration. 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). D57.432 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. D57.432 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. D57.432 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. D57.432 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 D57.432 map to under V28?

D57.432 maps to CMS-HCC V28 107 (Sickle Cell Anemia (Hb-SS) and Thalassemia Beta Zero). The category number and label come from the CMS-HCC V28 model file for payment year 2026.

What does D57.432 pay in RAF?

D57.432 carries a community, non-dual, aged (CNA) RAF weight of 0.457 under CMS-HCC V28 for payment year 2026. The weight comes from the CMS V28 relative-factor file, not a hand-typed table.

What is the V28 vs V24 difference for D57.432?

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 D57.432, V28 maps to Sickle Cell Anemia (Hb-SS) and Thalassemia Beta Zero at RAF 0.457 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 documentation supports D57.432?

This code requires documentation of both the sickle-cell thalassemia diagnosis AND the acute splenic sequestration event; do not assign this code if only the sickle-cell thalassemia is present without documented sequestration Splenic sequestration is a medical emergency requiring immediate treatment; verify the clinical documentation clearly states the sequestration episode and ensure this code is not confused with other sickle-cell complications like vaso-occlusive crisis Because D57.432 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 D57.432: Sickle-cell thalassemia

D57.432 maps to CMS-HCC V28 107 (RAF 0.457). Documentation must support MEAT. MEAT criteria · RAF calculator · HCC Buddy coding tools

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Code lookupD57.432Effective 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)

D57.432

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

Sickle-cell thalassemia beta zero with splenic sequestration

This is a serious blood disorder where a person has both sickle cell disease and a form of thalassemia, and their spleen is trapping and destroying blood cells faster than normal. This condition causes the spleen to become enlarged and can lead to severe anemia and other complications.

Buddy Insight

Splenic sequestration in sickle-cell thalassemia beta zero is an acute crisis where the spleen traps blood, causing rapid anemia and potential cardiovascular collapse.

CMS-HCC V28

Mapped

HCC 107

Sickle Cell Anemia (Hb-SS) an...

RAF 0.457

CMS-HCC V24

Mapped

HCC 46

Severe Hematological Disorders

RAF 1.372

ACA/HHS

Mapped

HCC 70

HHS-HCC 70

Varies by metal level

ESRD/PACE

Mapped

HCC 46

Severe Hematological Disorders

RAF 0.223

RXHCC

Mapped

HCC 95

Sickle Cell Anemia (Hb-SS) an...

Not separately weighted

Code Book Path

Official

D57.4Sickle-cell thalassemia

D57.43Sickle-cell thalassemia beta zero with crisis

D57.432Sickle-cell thalassemia beta zero with splenic sequestration

Inclusion Terms

Official

HbS-beta zero with splenic sequestration
Sickle-cell beta zero with splenic sequestration

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for D57.432 in this effective period.

Related Child Codes

Official

D57.431Sickle-cell thalassemia beta zero with acute chest syndrome

D57.433Sickle-cell thalassemia beta zero with cerebral vascular involvement

D57.434Sickle-cell thalassemia beta zero with dactylitis

D57.438Sickle-cell thalassemia beta zero with crisis with other specified complication

D57.439Sickle-cell thalassemia beta zero with crisis, unspecified

Includes

Official

ICD-10-CM does not list Includes notes for D57.432 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for D57.432 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for D57.432 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for D57.432 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for D57.432 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

Documentation must confirm sickle-cell thalassemia beta zero genotype and acute splenic sequestration with evidence of rapid splenic enlargement and hemoglobin decline.

Record splenic size (exam or imaging), hemoglobin trend from baseline, reticulocyte count, platelet count, treatment including transfusion, hemodynamic stability assessment, and whether splenectomy is planned.

MEAT Support

HCC Buddy guidance

Documentation must confirm sickle-cell thalassemia beta zero genotype and acute splenic sequestration with evidence of rapid splenic enlargement and hemoglobin decline.

Audit Caution

HCC Buddy guidance

Under V28, this maps to HCC 107 (RAF 0.727).

The code includes the underlying disease.

Beta-zero specification is important because the unspecified code maps to HCC 108 (RAF 0.607).

Ensure documentation distinguishes between splenic sequestration (acute blood pooling) and splenic infarction (vascular occlusion with tissue death).

Common Mistakes

HCC Buddy guidance

D57.432 vs. D57.412 (Unspecified sickle-cell thalassemia with splenic sequestration) -

D57.432 specifies beta-zero. D57.432 vs. D57.452 (Beta plus with splenic sequestration) -

beta-plus patients more commonly retain splenic function. D57.432 vs. D57.02 (Hemoglobin SS with splenic sequestration) -

clinically similar, genetically distinct.

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 D57.432 an HCC code?

Yes. D57.432 (Sickle-cell thalassemia beta zero with splenic sequestration) maps to Sickle Cell Anemia (Hb-SS) and Thalassemia Beta Zero under the CMS-HCC V28 risk adjustment model (and Severe Hematological Disorders under V24), with a community non-dual aged RAF of 0.457. It is billable for payment year 2026.

Coder answer: D57.432 is billable and maps to V28 HCC 107, Sickle Cell Anemia (Hb-SS) and Thalassemia Beta Zero. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.

Code: D57.432
Description: Sickle-cell thalassemia beta zero with splenic sequestration
HCC (V28): HCC 107 — Sickle Cell Anemia (Hb-SS) and Thalassemia Beta Zero
RAF: 0.457
Billable: Yes
Payment year: 2026

HCC Category Mapping

V28HCC 107, Sickle Cell Anemia (Hb-SS) and Thalassemia Beta Zero

0.457

V24HCC 46, Severe Hematological Disorders

1.372

ESRDHCC 46, Severe Hematological Disorders

0.223

RxHCCHCC 95, Sickle Cell Anemia (Hb-SS) and Thalassemia Beta Zero

Not separately weighted

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 D57.432 in the Code Book — tabular path, V28 RAF, and MEAT checklist →

MEAT Criteria for D57.432

For D57.432 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 D57.432 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

D57.432 is the ICD-10-CM diagnosis code for sickle-cell thalassemia beta zero with splenic sequestration. This is a serious blood disorder where a person has both sickle cell disease and a form of thalassemia, and their spleen is trapping and destroying blood cells faster than normal. This condition causes the spleen to become enlarged and can lead to severe anemia and other complications. D57.432 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, D57.432 maps to Sickle Cell Anemia (Hb-SS) and Thalassemia Beta Zero (HCC 107) with a community, non-dual, aged base RAF weight of 0.457. Under the older CMS-HCC V24 model, D57.432 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.

This code requires documentation of both the sickle-cell thalassemia diagnosis AND the acute splenic sequestration event; do not assign this code if only the sickle-cell thalassemia is present without documented sequestration. Because D57.432 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 D57.432 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•This code requires documentation of both the sickle-cell thalassemia diagnosis AND the acute splenic sequestration event; do not assign this code if only the sickle-cell thalassemia is present without documented sequestration
•Splenic sequestration is a medical emergency requiring immediate treatment; verify the clinical documentation clearly states the sequestration episode and ensure this code is not confused with other sickle-cell complications like vaso-occlusive crisis

Clinical Significance

Splenic sequestration in sickle-cell thalassemia beta zero is an acute crisis where the spleen traps blood, causing rapid anemia and potential cardiovascular collapse. Beta-zero patients may undergo autosplenectomy in childhood similar to Hemoglobin SS patients, making this complication more common in younger patients. However, some beta-zero patients retain splenic function longer depending on the specific thalassemia mutation and fetal hemoglobin levels.

Documentation Requirements

✓Documentation must confirm sickle-cell thalassemia beta zero genotype and acute splenic sequestration with evidence of rapid splenic enlargement and hemoglobin decline.
✓Record splenic size (exam or imaging), hemoglobin trend from baseline, reticulocyte count, platelet count, treatment including transfusion, hemodynamic stability assessment, and whether splenectomy is planned.

Commonly Confused Codes

•D57.432 vs. D57.412 (Unspecified sickle-cell thalassemia with splenic sequestration) -
•D57.432 specifies beta-zero. D57.432 vs. D57.452 (Beta plus with splenic sequestration) -
•beta-plus patients more commonly retain splenic function. D57.432 vs. D57.02 (Hemoglobin SS with splenic sequestration) -
•clinically similar, genetically distinct.