What is ICD-10 code D59.2?

D59.2 is the ICD-10-CM diagnosis code for Drug-induced nonautoimmune hemolytic anemia. Anemia caused by the destruction of red blood cells as a side effect of certain medications, without an immune system mechanism. D59.2 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. D59.2 is part of the FY2026 ICD-10-CM code set published by the CMS National Center for Health Statistics and used on Medicare, Medicaid, and commercial claims in the United States.

Yes. D59.2 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. D59.2 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

Which HCC does D59.2 map to under V28?

D59.2 has no payable CMS-HCC V28 mapping in the final FY2026 CMS file.

What RAF reference is published for D59.2?

D59.2 has no V28 reference coefficient because the final FY2026 source verifies no payable V28 mapping.

What is the V28 vs V24 difference for D59.2?

D59.2 has verified no payable V28 mapping in the final FY2026 source. Select a historical effective period before making any V24 comparison.

What documentation supports D59.2?

Always identify and document the specific drug causing the hemolytic anemia in the medical record Use an additional code from category T36-T50 to identify the drug responsible for the adverse effect D59.2 is not a CMS-HCC V28 payment code in the verified current source, so MEAT is not the payment hook. Documentation still has to support the diagnosis if you report it.

2026 ICD-10-CM D59.2: Drug-induced nonautoimmune hemolytic

D59.2 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · HCC coding software

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Code lookupD59.2

Effective periodFY2026 Apr Update (Apr 1-Sep 30)

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)

D59.2

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

Drug-induced nonautoimmune hemolytic anemia

Anemia caused by the destruction of red blood cells as a side effect of certain medications, without an immune system mechanism.

Buddy Insight

Overview Risk Models Code Book Documentation Audit Notes Edition comparison

CMS-HCC V28

N/A

—

Not risk-adjusted for this model/period.

Not mapped

CMS-HCC V24

Historical

Not used for standard CY2026 Medicare Advantage payment. Select a historical period to review V24.

Not used for CY2026 payment

ACA/HHS

Mapped

HCC 069

HHS-HCC 069 adult, RAF varies...

Code-level coefficient reference

ESRD/PACE

Mapped

HCC 46

Severe Hematological Disorders

Code-level coefficient reference

RXHCC

Mapped

HCC 96

Acquired Hemolytic, Aplastic,...

Code-level coefficient reference

Code Book Path

Official

D59Acquired hemolytic anemia D59.2Drug-induced nonautoimmune hemolytic anemia

Inclusion Terms

Official

Drug-induced enzyme deficiency anemia

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

D59.0Drug-induced autoimmune hemolytic anemia D59.1Other autoimmune hemolytic anemias D59.3Hemolytic-uremic syndrome D59.4Other nonautoimmune hemolytic anemias D59.5Paroxysmal nocturnal hemoglobinuria [Marchiafava-Micheli]

Includes

Official

No Includes notes are included in this display for D59.2. Check the code and parent instructions in the Code Book.

Excludes 1

Official

No Excludes 1 notes are included in this display for D59.2. Check the code and parent instructions in the Code Book.

Code First

Official

No Code First sequencing instructions are included in this display for D59.2. Check the code and parent instructions in the Code Book.

Use Additional

Official

code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5)

Code Also

Official

No Code Also instructions are included in this display for D59.2. Check the code and parent instructions in the Code Book.

Buddy Documentation Tip

HCC Buddy guidance

Document the specific causative drug or toxin by name with temporal relationship to hemolysis onset.

Record a negative direct antiglobulin (Coombs) test to confirm non-autoimmune mechanism.

Include hemoglobin values, peripheral blood smear findings (Heinz bodies, bite cells for oxidative damage), and hemolysis markers.

Use additional external cause codes (T36-T50) to identify the responsible drug.

MEAT Support

HCC Buddy guidance

Document the specific causative drug or toxin by name with temporal relationship to hemolysis onset.

Record a negative direct antiglobulin (Coombs) test to confirm non-autoimmune mechanism.

Include hemoglobin values, peripheral blood smear findings (Heinz bodies, bite cells for oxidative damage), and hemolysis markers.

Use additional external cause codes (T36-T50) to identify the responsible drug.

Audit Caution

HCC Buddy guidance

Always pair this code with the appropriate external cause code identifying the responsible drug -

the code is incomplete without it. Do not confuse with drug-induced autoimmune hemolytic anemia (D59.0), which has a positive Coombs test. When glucose-6-phosphate dehydrogenase deficiency is the predisposing factor, code both the enzyme deficiency (D55.0) and the drug-induced hemolysis. Resolution after drug discontinuation helps confirm the diagnosis.

Common Mistakes

HCC Buddy guidance

D59.0 (Drug-induced autoimmune hemolytic anemia) involves immune-mediated destruction with positive Coombs test.

D55.0 (Anemia due to glucose-6-phosphate dehydrogenase deficiency) should be coded as the underlying susceptibility when the enzyme deficiency is the reason for drug sensitivity.

D59.4 (Other nonautoimmune hemolytic anemias) covers non-drug causes of nonautoimmune hemolysis.

T36-T50 external cause codes must accompany this diagnosis.

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 D59.2 an HCC code?

D59.2 is not in the CMS-HCC V28 or V24 community payment model. D59.2 has a separate mapping under the CMS-HCC ESRD model (HCC 46 (Severe Hematological Disorders)) and the Part D RxHCC model (HCC 96 (Acquired Hemolytic, Aplastic, and Sideroblastic Anemias)); the applicable result needs member context. D59.2 also appears in the HHS-HCC commercial risk model (HCC 069 (HHS-HCC 069 adult, RAF varies by metal level)), which is a commercial market model rather than a Medicare Advantage payment mapping.

Code: D59.2
Description: Drug-induced nonautoimmune hemolytic anemia
HCC (V28): No CMS-HCC V28 mapping
RAF reference coefficient: —
Billable: Yes
Payment year: 2026

HCC Category Mapping

ESRDHCC 46, Severe Hematological Disorders

Not separately weighted

RxHCCHCC 96, Acquired Hemolytic, Aplastic, and Sideroblastic Anemias

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 D59.2 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT review for D59.2

For D59.2, 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

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What This Code Means

D59.2 is the ICD-10-CM diagnosis code for drug-induced nonautoimmune hemolytic anemia. Anemia caused by the destruction of red blood cells as a side effect of certain medications, without an immune system mechanism. D59.2 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).

D59.2 has no mapping under the CMS-HCC V28 or V24 community payment models. D59.2 has a separate mapping under the CMS-HCC ESRD model (HCC 46 (Severe Hematological Disorders)) and the Part D RxHCC model (HCC 96 (Acquired Hemolytic, Aplastic, and Sideroblastic Anemias)); the applicable result needs member context. D59.2 also appears in the HHS-HCC commercial risk model (HCC 069 (HHS-HCC 069 adult, RAF varies by metal level)), which is a commercial market model rather than a Medicare Advantage payment mapping. Do not assign V28 risk adjustment value from this page; verify the applicable model and payment year before using this code for risk adjustment.

Always identify and document the specific drug causing the hemolytic anemia in the medical record.

HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for D59.2 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Always identify and document the specific drug causing the hemolytic anemia in the medical record
•Use an additional code from category T36-T50 to identify the drug responsible for the adverse effect

Clinical Significance

Drug-induced nonautoimmune hemolytic anemia occurs when medications directly damage red blood cells through oxidative stress, direct membrane toxicity, or other non-immune mechanisms, leading to accelerated hemolysis. The most well-known example is oxidative hemolysis from drugs such as dapsone, primaquine, or sulfonamides, particularly in patients with glucose-6-phosphate dehydrogenase deficiency. Unlike drug-induced autoimmune hemolytic anemia, the direct antiglobulin (Coombs) test is negative because antibodies are not involved in the hemolytic process.

Documentation Requirements

✓Document the specific causative drug or toxin by name with temporal relationship to hemolysis onset.
✓Record a negative direct antiglobulin (Coombs) test to confirm non-autoimmune mechanism.
✓Include hemoglobin values, peripheral blood smear findings (Heinz bodies, bite cells for oxidative damage), and hemolysis markers.
✓Use additional external cause codes (T36-T50) to identify the responsible drug.
✓Document glucose-6-phosphate dehydrogenase status if relevant to the mechanism.

Use Additional Code

code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5)

Commonly Confused Codes

•D59.0 (Drug-induced autoimmune hemolytic anemia) involves immune-mediated destruction with positive Coombs test.
•D55.0 (Anemia due to glucose-6-phosphate dehydrogenase deficiency) should be coded as the underlying susceptibility when the enzyme deficiency is the reason for drug sensitivity.
•D59.4 (Other nonautoimmune hemolytic anemias) covers non-drug causes of nonautoimmune hemolysis.
•T36-T50 external cause codes must accompany this diagnosis.