D59.2

Billable

Drug-induced nonautoimmune hemolytic anemia

HCC Category Mapping

V24HCC 46 — Severe Hematological Disorders

0.666

ESRDHCC 46 — Severe Hematological Disorders

0.000

RxHCCHCC 96 — Hemolytic and Aplastic Anemias

0.000

What This Code Means

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

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.