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D57.813 ICD-10-CM Code: Other sickle-cell disorders with cerebral vascular involvement

D57.813 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 Buddy coding tools

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Code lookupD57.813

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)

D57.813

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

Other sickle-cell disorders with cerebral vascular involvement

A rare sickle-cell disorder with stroke or blood vessel problems affecting the brain.

Buddy the Bee presenting code insight

Buddy Insight

Other sickle-cell disorders with cerebral vascular involvement captures stroke or cerebrovascular events occurring in patients with rare sickle-cell variants.

OverviewRisk ModelsCode BookDocumentationAuditNotesEdition comparison

CMS-HCC V28

HCC 108

Coefficient HCC 108: 0.146 (Community Non-Dual Aged (CNA))

CMS-HCC V24

Historical

Historical

Not used for CY2026 payment

ACA/HHS

HCC 071

Code-level coefficient reference

ESRD/PACE

HCC 46

Code-level coefficient reference

RXHCC

N/A

—

Not mapped

Code Book Path

Official
D57.8Other sickle-cell disordersD57.81Other sickle-cell disorders with crisisD57.813Other sickle-cell disorders with cerebral vascular involvement

Inclusion Terms

Official
  • Hb-SD diseaseInherited from D57.8
  • Hb-SE diseaseInherited from D57.8

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
D57.811Other sickle-cell disorders with acute chest syndromeD57.812Other sickle-cell disorders with splenic sequestrationD57.814Other sickle-cell disorders with dactylitisD57.818Other sickle-cell disorders with crisis with other specified complicationD57.819Other sickle-cell disorders with crisis, unspecified

Includes

Official

No Includes notes are included in this display for D57.813. 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 D57.813. Check the code and parent instructions in the Code Book.

Use Additional

Official
  • code for any associated fever (R50.81)Inherited from D57

Code Also

Official
  • , if applicable: cerebral infarction (I63.-)

Buddy Documentation Tip

HCC Buddy guidance
Document the specific sickle-cell variant and the type of cerebrovascular event (ischemic stroke, hemorrhagic stroke, transient ischemic attack, or moyamoya disease).
Include neuroimaging results (magnetic resonance imaging, magnetic resonance angiography, or computed tomography).
Record neurological examination findings, National Institutes of Health Stroke Scale score if applicable, and any residual deficits.
Document treatment including exchange transfusion, chronic transfusion program, and hydroxyurea therapy.

MEAT Support

HCC Buddy guidance
Document the specific sickle-cell variant and the type of cerebrovascular event (ischemic stroke, hemorrhagic stroke, transient ischemic attack, or moyamoya disease).
Include neuroimaging results (magnetic resonance imaging, magnetic resonance angiography, or computed tomography).
Record neurological examination findings, National Institutes of Health Stroke Scale score if applicable, and any residual deficits.
Document treatment including exchange transfusion, chronic transfusion program, and hydroxyurea therapy.

Audit Caution

HCC Buddy guidance
Do not code cerebral vascular involvement without documented neurological findings or imaging confirmation.
Silent cerebral infarcts found incidentally on imaging still qualify for this code when documented.
Ensure additional stroke-specific codes are assigned when the type of cerebrovascular event is known.
Query the provider to distinguish between acute stroke and chronic cerebrovascular changes.

Common Mistakes

HCC Buddy guidance
D57.03 (Hemoglobin SS disease with cerebral vascular involvement) is for homozygous sickle-cell disease specifically.
D57.213 (Sickle-cell/hemoglobin C disease with cerebral vascular involvement) applies to the hemoglobin SC variant.
I63.x (Cerebral infarction) codes may be used additionally to specify the type of stroke but should not replace the sickle-cell specific code.

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 D57.813 an HCC code?

Yes. D57.813 (Other sickle-cell disorders with cerebral vascular involvement) 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: D57.813 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
D57.813
Description
Other sickle-cell disorders with cerebral vascular involvement
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 D57.813 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT review for D57.813

For D57.813, 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

D57.813 is the ICD-10-CM diagnosis code for other sickle-cell disorders with cerebral vascular involvement. A rare sickle-cell disorder with stroke or blood vessel problems affecting the brain. D57.813 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, D57.813 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 D57.813; 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.

Cerebral vascular involvement is a serious complication; ensure imaging or clinical evidence supports this diagnosis. For D57.813, 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 D57.813 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • •Cerebral vascular involvement is a serious complication; ensure imaging or clinical evidence supports this diagnosis
  • •Document whether this is a stroke, transient ischemic attack, or other cerebral vascular event

Clinical Significance

Other sickle-cell disorders with cerebral vascular involvement captures stroke or cerebrovascular events occurring in patients with rare sickle-cell variants. Sickle-cell disease is a major risk factor for both ischemic and hemorrhagic stroke, with cerebrovascular disease affecting up to 11% of sickle-cell patients by age 20. This condition may present as acute stroke, transient ischemic attack, or silent cerebral infarction, and requires urgent neurological evaluation and chronic transfusion therapy.

Documentation Requirements

  • ✓Document the specific sickle-cell variant and the type of cerebrovascular event (ischemic stroke, hemorrhagic stroke, transient ischemic attack, or moyamoya disease).
  • ✓Include neuroimaging results (magnetic resonance imaging, magnetic resonance angiography, or computed tomography).
  • ✓Record neurological examination findings, National Institutes of Health Stroke Scale score if applicable, and any residual deficits.
  • ✓Document treatment including exchange transfusion, chronic transfusion program, and hydroxyurea therapy.

Code Also

  • , if applicable: cerebral infarction (I63.-)

Commonly Confused Codes

  • •D57.03 (Hemoglobin SS disease with cerebral vascular involvement) is for homozygous sickle-cell disease specifically.
  • •D57.213 (Sickle-cell/hemoglobin C disease with cerebral vascular involvement) applies to the hemoglobin SC variant.
  • •I63.x (Cerebral infarction) codes may be used additionally to specify the type of stroke but should not replace the sickle-cell specific code.

Child Codes

D57.811Other sickle-cell disorders with acute chest syndrome
HCC 108
D57.812Other sickle-cell disorders with splenic sequestration
HCC 108
D57.813Other sickle-cell disorders with cerebral vascular involvement
HCC 108
D57.814Other sickle-cell disorders with dactylitis
HCC 108
D57.818Other sickle-cell disorders with crisis with other specified complication
HCC 108
D57.819Other sickle-cell disorders with crisis, unspecified
HCC 108

Code Hierarchy

└D57Sickle-cell disorders└D57.8Other sickle-cell disorders└D57.81Other sickle-cell disorders with crisis└D57.813Other sickle-cell disorders with cerebral vascular involvement
└D57.813Other sickle-cell disorders with cerebral vascular involvement

D57.813 code history

Code setChange
FY2021 (effective Oct 1, 2020)Added to the code set

Source: official CMS ICD-10-CM order and addenda files, FY2016 through FY2027.

Also searched as

  • D57 813
  • D57813

For D57.813, 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.

D57.813 maps to CMS-HCC V28 category 108, Sickle Cell Disorders, Except Sickle Cell Anemia (Hb-SS) and Thalassemia Beta Zero; Beta Thalassemia Major. See the ICD-10 to HCC mapping hub for how the V28 crosswalk works. The mapping identifies a payment HCC category for D57.813. Review its source-labeled HCC coefficient above, check the RAF Calculator with complete member context for CMS-HCC V28 PY2026, and confirm the documentation the chart needs before the code is submitted. HCC Buddy shows no RAF score unless every required source and calculation check passes.

Work D57.813 in HCC Buddy

Open D57.813 in the Code Book for the full Index-to-Tabular path, MEAT checklist, and V28 HCC mapping, or in the Encoder to code from a keyword search. Pro includes 7 days to try everything, no card required.

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