D57.818 ICD-10-CM Code: Other sickle-cell disorders with crisis with other specified complication
D57.818 maps to CMS-HCC V28 108 (RAF 0.146). Documentation must support MEAT. MEAT criteria · RAF calculator · free HCC coding tools
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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)
D57.818
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceOther sickle-cell disorders with crisis with other specified complication
A rare sickle-cell disorder experiencing a crisis with another specific complication not listed in standard categories.
Buddy Insight
Other sickle-cell disorders with crisis with other specified complication captures acute sickle-cell crises in rare variants that present with complications not classifiable to acute chest syndrome, splenic sequestration, cerebral vascular involvement, or dactylitis.
CMS-HCC V28
MappedHCC 108
RAF 0.146
CMS-HCC V24
MappedHCC 46
RAF 1.372
ACA/HHS
MappedHCC 71
Varies by metal level
ESRD/PACE
MappedHCC 46
RAF 0.223
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for D57.818 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for D57.818 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for D57.818 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for D57.818 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for D57.818 in this effective period.
Use Additional
Official- code to identify complications, such as:
- cholelithiasis (K80.-)
- priapism (N48.32)
Code Also
OfficialICD-10-CM does not list Code Also instructions for D57.818 in this effective period.
Buddy Documentation Tip
MEAT Support
Audit Caution
Common Mistakes
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 D57.818 an HCC code?
Yes. D57.818 (Other sickle-cell disorders with crisis with other specified complication) maps to Sickle Cell Disorders, Except Sickle Cell Anemia (Hb-SS) and Thalassemia Beta Zero; Beta Thalassemia Major under the CMS-HCC V28 risk adjustment model (and Severe Hematological Disorders under V24), with a community non-dual aged RAF of 0.146. It is billable for payment year 2026.
Coder answer: D57.818 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
- D57.818
- Description
- Other sickle-cell disorders 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
- 0.146
- Billable
- Yes
- Payment year
- 2026
HCC Category Mapping
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 D57.818 in the Code Book — tabular path, V28 RAF, and MEAT checklist →
MEAT Criteria for D57.818
For D57.818 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 D57.818 during that encounter, not just copy-forwarded from a problem list.
Coder workflow notes
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What This Code Means
D57.818 is the ICD-10-CM diagnosis code for other sickle-cell disorders with crisis with other specified complication. A rare sickle-cell disorder experiencing a crisis with another specific complication not listed in standard categories. D57.818 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, D57.818 maps to Sickle Cell Disorders, Except Sickle Cell Anemia (Hb-SS) and Thalassemia Beta Zero; Beta Thalassemia Major (HCC 108) with a community, non-dual, aged base RAF weight of 0.146. Under the older CMS-HCC V24 model, D57.818 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.
Use this code when a crisis is present with a complication that doesn't fit other defined categories. Because D57.818 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 D57.818 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Use this code when a crisis is present with a complication that doesn't fit other defined categories
- •Document the specific nature of both the crisis and the additional complication
Clinical Significance
Other sickle-cell disorders with crisis with other specified complication captures acute sickle-cell crises in rare variants that present with complications not classifiable to acute chest syndrome, splenic sequestration, cerebral vascular involvement, or dactylitis. Examples include priapism, hepatic sequestration, aplastic crisis from parvovirus B19 infection, or acute renal failure during crisis. These complications require targeted management in addition to standard sickle-cell crisis treatment.
Documentation Requirements
- ✓Document the specific sickle-cell variant, the nature of the crisis, and the specific complication by name.
- ✓Include relevant laboratory and imaging findings supporting both the crisis state and the complication.
- ✓Record treatment directed at both the crisis and the specific complication.
- ✓Document any prior similar episodes and the patient's baseline disease status.
Commonly Confused Codes
- •D57.09/D57.219 (Hemoglobin SS or SC disease with crisis with other specified complication) apply to specific sickle-cell variants rather than 'other' types.
- •D57.819 (Other sickle-cell disorders with crisis, unspecified) should not be used when the complication is specified.
- •Use the most specific crisis complication code available (D57.811-D57.814) before defaulting to D57.818.