D58.2 ICD-10-CM Code: Other hemoglobinopathies
D58.2 is not a CMS-HCC payment code. MEAT criteria · RAF calculator · HCC Buddy 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)
D58.2
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceOther hemoglobinopathies
A group of inherited blood disorders involving abnormal hemoglobin (the protein that carries oxygen in red blood cells), such as sickle cell disease or thalassemia.
Buddy Insight
Other hemoglobinopathies encompasses a diverse group of inherited disorders of hemoglobin structure or production not classified under sickle-cell disease or thalassemia major categories, including unstable hemoglobin variants, hemoglobins with altered oxygen affinity, and methemoglobinemias.
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
MappedHCC 48
RAF 0.192
ACA/HHS
N/A—
Not mapped
ESRD/PACE
MappedHCC 48
RAF 0.063
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
Official- Abnormal hemoglobin NOS
- Congenital Heinz body anemia
- Hb-C disease
- Hb-D disease
- Hb-E disease
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for D58.2 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for D58.2 in this effective period.
Excludes 1
Official- familial polycythemia (D75.0)
- Hb-M disease (D74.0)
- hemoglobin E-beta thalassemia (D56.5)
- hereditary persistence of fetal hemoglobin [HPFH] (D56.4)
- high-altitude polycythemia (D75.1)
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for D58.2 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for D58.2 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for D58.2 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 D58.2 an HCC code?
Yes. D58.2 maps to Coagulation Defects and Other Specified Hematological Disorders under the V24 model but is not retained in V28.
- Code
- D58.2
- Description
- Other hemoglobinopathies
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF
- —
- 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 D58.2 in the Code Book — tabular path, V28 RAF, and MEAT checklist →
MEAT Criteria for D58.2
For D58.2 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 D58.2 during that encounter, not just copy-forwarded from a problem list.
Coder workflow notes
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What This Code Means
D58.2 is the ICD-10-CM diagnosis code for other hemoglobinopathies. A group of inherited blood disorders involving abnormal hemoglobin (the protein that carries oxygen in red blood cells), such as sickle cell disease or thalassemia. D58.2 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 older CMS-HCC V24 model, D58.2 maps to Coagulation Defects and Other Specified Hematological Disorders (HCC 48) with a community, non-dual, aged base RAF weight of 0.192. 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 additional codes to specify the type of hemoglobinopathy when documented. Because D58.2 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 D58.2 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Use additional codes to specify the type of hemoglobinopathy when documented
- •Document any acute complications like vaso-occlusive crises separately
Clinical Significance
Other hemoglobinopathies encompasses a diverse group of inherited disorders of hemoglobin structure or production not classified under sickle-cell disease or thalassemia major categories, including unstable hemoglobin variants, hemoglobins with altered oxygen affinity, and methemoglobinemias. Clinical severity varies widely from asymptomatic carrier states to severe hemolytic anemia depending on the specific hemoglobin variant. Over 1,000 hemoglobin variants have been identified, though only a fraction cause clinically significant disease.
Documentation Requirements
- ✓Document the specific hemoglobin variant by name when identified through hemoglobin electrophoresis, high-performance liquid chromatography, or genetic testing.
- ✓Record baseline hemoglobin levels, evidence of hemolysis if present, and oxygen-carrying capacity.
- ✓Include family history of hemoglobinopathy and any genetic counseling provided.
- ✓Document any complications such as chronic hemolytic anemia, gallstones, or iron overload.
Excludes 1, Do NOT code together
Commonly Confused Codes
- •D57.x (Sickle-cell disorders) should be used when sickle hemoglobin is present rather than D58.
- •D56.x (Thalassemia) codes are preferred when thalassemia is the documented diagnosis. D58.0 (Hereditary spherocytosis) and D58.1 (Hereditary elliptocytosis) are membrane disorders, not hemoglobinopathies. D64.x (Other anemias) may overlap in presentation but has different underlying pathology.