D59.8 ICD-10-CM Code: Other acquired hemolytic anemias
D59.8 maps to CMS-HCC V28 109 (RAF 1.144). Documentation must support MEAT. MEAT criteria · RAF calculator · HCC coding software
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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)
D59.8
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceOther acquired hemolytic anemias
Anemia caused by the destruction of red blood cells due to acquired conditions not classified in other hemolytic anemia categories.
Buddy Insight
Other acquired hemolytic anemias is a residual category for acquired conditions causing premature red blood cell destruction that do not fit into the autoimmune, drug-induced, hemolytic-uremic syndrome, or external cause categories.
CMS-HCC V28
MappedHCC 109
RAF 1.144
CMS-HCC V24
MappedHCC 46
RAF 1.372
ACA/HHS
MappedHCC 69
Varies by metal level
ESRD/PACE
MappedHCC 46
RAF 0.223
RXHCC
MappedHCC 96
RAF 0.722
Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for D59.8 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for D59.8 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for D59.8 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for D59.8 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for D59.8 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for D59.8 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for D59.8 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 D59.8 an HCC code?
Yes. D59.8 (Other acquired hemolytic anemias) maps to Acquired Hemolytic, Aplastic, and Sideroblastic Anemias under the CMS-HCC V28 risk adjustment model (and Severe Hematological Disorders under V24), with a community non-dual aged RAF of 1.144. It is billable for payment year 2026.
Coder answer: D59.8 is billable and maps to V28 HCC 109, Acquired Hemolytic, Aplastic, and Sideroblastic Anemias. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.
- Code
- D59.8
- Description
- Other acquired hemolytic anemias
- HCC (V28)
- HCC 109 — Acquired Hemolytic, Aplastic, and Sideroblastic Anemias
- RAF
- 1.144
- 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 D59.8 in the Code Book — tabular path, V28 RAF, and MEAT checklist →
MEAT Criteria for D59.8
For D59.8 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 D59.8 during that encounter, not just copy-forwarded from a problem list.
Coder workflow notes
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What This Code Means
D59.8 is the ICD-10-CM diagnosis code for other acquired hemolytic anemias. Anemia caused by the destruction of red blood cells due to acquired conditions not classified in other hemolytic anemia categories. D59.8 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 CMS-HCC V28 risk adjustment model, D59.8 maps to Acquired Hemolytic, Aplastic, and Sideroblastic Anemias (HCC 109) with a community, non-dual, aged base RAF weight of 1.144. Under the older CMS-HCC V24 model, D59.8 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.
This is a catch-all code; document the specific cause of hemolysis to support medical necessity. Because D59.8 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 D59.8 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This is a catch-all code; document the specific cause of hemolysis to support medical necessity
- •Ensure the condition is truly acquired and not congenital or hereditary
Clinical Significance
Other acquired hemolytic anemias is a residual category for acquired conditions causing premature red blood cell destruction that do not fit into the autoimmune, drug-induced, hemolytic-uremic syndrome, or external cause categories. This may include hemolysis associated with infections (malaria-related hemolysis coded elsewhere, but other parasitic or bacterial infections causing hemolysis), mechanical hemolysis from malfunctioning prosthetic devices, or hemolysis associated with liver disease or hypersplenism. The acquired nature distinguishes these from hereditary hemolytic anemias.
Documentation Requirements
- ✓Document the specific cause or mechanism of acquired hemolysis when identifiable.
- ✓Record laboratory evidence of hemolysis (low haptoglobin, elevated lactate dehydrogenase, elevated indirect bilirubin, reticulocytosis) and hemoglobin values.
- ✓Include negative direct antiglobulin test if autoimmune causes have been excluded.
- ✓Document any underlying conditions contributing to hemolysis and the treatment approach.
- ✓Clarify that the condition is acquired rather than hereditary.
Commonly Confused Codes
- •D59.0-D59.6 provide more specific acquired hemolytic anemia codes and should be used when applicable.
- •D58.x (Hereditary hemolytic anemias) codes are for inherited conditions.
- •D59.9 (Acquired hemolytic anemia, unspecified) is even less specific.
- •D64.9 (Anemia, unspecified) should not be used when hemolytic anemia is confirmed.
- •The 'other specified' designation of D59.8 is preferred over D59.9 when the cause is known but no specific code exists.