D59.31

Billable

Infection-associated hemolytic-uremic syndrome

HCC Category Mapping

V28HCC 109 — Hemolytic and Aplastic Anemias

0.291

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

A serious condition where an infection triggers the destruction of red blood cells and kidney failure.

Coding Tips

•Identify and code the causative infection separately (typically E. coli O157:H7 or other Shiga toxin-producing organisms)
•Document the specific infectious agent when available to support medical necessity

Clinical Significance

Infection-associated hemolytic-uremic syndrome (typical hemolytic-uremic syndrome) is most commonly caused by Shiga toxin-producing Escherichia coli (particularly serotype O157:H7) and accounts for approximately 90% of all hemolytic-uremic syndrome cases, predominantly affecting children under age 5. The Shiga toxin damages endothelial cells in renal glomeruli, triggering the characteristic triad of microangiopathic hemolytic anemia, thrombocytopenia, and acute kidney injury. Most cases are preceded by a prodromal bloody diarrheal illness 5-10 days before hemolytic-uremic syndrome onset.

Documentation Requirements

✓Document the causative infectious organism with culture or polymerase chain reaction results when available.
✓Record the prodromal illness (typically bloody diarrhea) with timeline to hemolytic-uremic syndrome onset.
✓Include laboratory values: creatinine, hemoglobin, platelet count, peripheral smear showing schistocytes, lactate dehydrogenase, and stool studies.
✓Document renal function status, any dialysis requirement, and complications such as seizures, pancreatitis, or colonic necrosis.
✓Code the infectious organism separately.

Use Additional Code

code to identify associated infection, such as :
E. coli infection (B96.2-)
Human immunodeficiency virus [HIV] disease (B20)
Pneumococcal meningitis (G00.1)
Pneumococcal pneumonia (J13)
Sepsis due to Streptococcus pneumoniae (A40.3)
Shigella dysenteriae (A03.9)
Streptococcus pneumoniae as the cause of diseases classified elsewhere (B95.3)

Commonly Confused Codes

D59.32 (Hereditary hemolytic-uremic syndrome) involves genetic complement pathway defects without infectious trigger.D59.39 (Other hemolytic-uremic syndrome) covers non-infectious, non-hereditary causes.D59.30 (Hemolytic-uremic syndrome, unspecified) should not be used when the infectious etiology is confirmed.A04.7 (Enterocolitis due to Clostridium difficile) or B96.2x (Escherichia coli) may be needed as additional codes for the causative organism.

Code Hierarchy

└D59Acquired hemolytic anemia └D59.3Hemolytic-uremic syndrome └D59.31Infection-associated hemolytic-uremic syndrome

└D59.31Infection-associated hemolytic-uremic syndrome