D57.453
BillableSickle-cell thalassemia beta plus with cerebral vascular involvement
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is D57.453 an HCC code?
Yes. D57.453 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 D57.453
For D57.453 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 D57.453 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
D57.453 is the ICD-10-CM diagnosis code for sickle-cell thalassemia beta plus with cerebral vascular involvement. A blood disorder combining sickle-cell disease and thalassemia that causes stroke or blood vessel problems in the brain. D57.453 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, D57.453 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, D57.453 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 serious complication affecting cerebral blood vessels; ensure documentation clearly supports the cerebral vascular involvement. Because D57.453 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 D57.453 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This code indicates a serious complication affecting cerebral blood vessels; ensure documentation clearly supports the cerebral vascular involvement
- •Verify the specific type of sickle-cell thalassemia (beta plus) is documented before assigning this code
Clinical Significance
Cerebral vascular involvement in sickle-cell thalassemia beta plus is less common than in Hemoglobin SS or beta-zero genotypes due to the milder disease phenotype, but it can still occur with devastating consequences. The higher baseline hemoglobin in beta-plus patients may contribute to hyperviscosity-related cerebrovascular events, particularly during dehydration or acute illness. Stroke prevention screening protocols should still be followed.
Documentation Requirements
- ✓Documentation must confirm sickle-cell thalassemia beta plus genotype and the cerebrovascular event with neurological examination and neuroimaging results.
- ✓Record the stroke type, neurological deficits, treatment (exchange transfusion targeting Hemoglobin S reduction), and follow-up plan including chronic transfusion therapy consideration and neurological rehabilitation.
- ✓Document transcranial Doppler velocities if available.
Code Also
- , if applicable cerebral infarction (I63.-)
Commonly Confused Codes
- •D57.453 vs. D57.433 (Beta zero with cerebral vascular involvement) -
- •beta-zero has higher stroke risk and higher HCC mapping. D57.453 vs. D57.413 (Unspecified with cerebral vascular involvement) -
- •D57.453 specifies beta-plus. D57.453 vs. D57.03 (Hemoglobin SS with cerebral vascular involvement) -
- •different genotype.