D57.44
BillableSickle-cell thalassemia beta plus without crisis
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is D57.44 an HCC code?
Yes. D57.44 maps to Sickle Cell Disorders and Thalassemia under the CMS-HCC V28 risk adjustment model (and Severe Hematological Disorders under V24).
HCC Category Mapping
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 D57.44
For D57.44 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 D57.44 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
D57.44 is the ICD-10-CM diagnosis code for sickle-cell thalassemia beta plus without crisis. A combination blood disorder with sickle-cell and thalassemia beta-plus that is stable without an active crisis or acute complications. D57.44 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, D57.44 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, D57.44 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.
This code indicates a non-crisis state; ensure no acute symptoms or complications are documented that would require a crisis code (D57.45x). Because D57.44 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 D57.44 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This code indicates a non-crisis state; ensure no acute symptoms or complications are documented that would require a crisis code (D57.45x)
- •Use this code for routine follow-up visits or when the patient is in remission from acute episodes
Clinical Significance
Sickle-cell thalassemia beta plus without crisis represents the chronic baseline state of patients co-inheriting a sickle hemoglobin gene and a beta-plus thalassemia gene (reduced but not absent beta-globin production). This genotype generally produces a milder clinical phenotype than Hemoglobin SS or beta-zero sickle-cell thalassemia because some normal hemoglobin A is produced, typically comprising 15-30% of total hemoglobin. Patients have milder anemia and fewer crises but remain at risk for all sickle cell complications.
Documentation Requirements
- ✓Document the sickle-cell thalassemia beta plus genotype confirmed by hemoglobin electrophoresis (showing Hemoglobin S predominance with measurable Hemoglobin A, usually 15-30%) or molecular testing.
- ✓Confirm no acute crisis at the encounter.
- ✓Record baseline hemoglobin (typically 9-12 g/dL), medications, transfusion history if any, and screening results for retinopathy, avascular necrosis, renal function, and pulmonary hypertension.