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.

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

CMS phased in the V28 risk adjustment model over payment years 2024 (33%), 2025 (67%), and 2026 (100%), replacing V24. V28 consolidates HCC categories, removes some lower-acuity conditions, and recalibrates RAF weights across the entire model. D59.2 was a payment HCC under V24 (Severe Hematological Disorders) but the V28 recalibration removed it from the risk adjustment model. Both models can still appear in legacy data and in payer-specific lookback periods.

What should coders know when reporting 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 Because D59.2 maps to a payment HCC, the documentation must also satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's risk adjustment score.

D59.2: Drug-induced nonautoimmune hemolytic anemia — ICD-10 | Severe Hematological Disorders

ICD-10-CM Code View

HCC Buddy Code Card

Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.

Code lookupD59.2Effective 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

CMS-HCC V28

Not risk-adjusted for this model/period.

RAF 0

CMS-HCC V24

Mapped

HCC 46

Severe Hematological Disorders

RAF 1.372

ACA/HHS

Not risk-adjusted for this model/period.

RAF 0

ESRD/PACE

Mapped

HCC 46

Severe Hematological Disorders

RAF 0.0

RXHCC

Mapped

HCC 96

Hemolytic and Aplastic Anemias

RAF 0.0

Code Trumping

Basket needed

Compare selected patient codes to show trumped or trumps impact.

Code Book Path

Official

D59Acquired hemolytic anemia

D59.2Drug-induced nonautoimmune hemolytic anemia

Inclusion Terms

Official

Drug-induced enzyme deficiency anemia

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for D59.2 in this effective period.

Related Child 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

ICD-10-CM does not list Includes notes for D59.2 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for D59.2 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for D59.2 in this effective period.

Use Additional

Official

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

Code Also

Official

ICD-10-CM does not list Code Also instructions for D59.2 in this effective period.

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.

Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.

Is D59.2 an HCC code?

Yes. D59.2 maps to Severe Hematological Disorders under the V24 model but is not retained in V28.

HCC Category Mapping

V24HCC 46, Severe Hematological Disorders

1.372

ESRDHCC 46, Severe Hematological Disorders

0.000

RxHCCHCC 96, Hemolytic and Aplastic Anemias

0.000

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.

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

MEAT Criteria for D59.2

For D59.2to 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 D59.2 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

Get the V28 RAF + MEAT cheat sheet

One printable page: confirm a code's V28 HCC status, its RAF weight, and the MEAT your note needs to make it stick. Free, no card.

Free PDF. No card. Unsubscribe anytime.

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).

Under the older CMS-HCC V24 model, D59.2 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.

Always identify and document the specific drug causing the hemolytic anemia in the medical record. Because D59.2 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 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.