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2025 ICD-10-CM code D58

Other hereditary hemolytic anemias. This code excludes hemolytic anemia of the newborn (P55.-).

Use this code when the specific type of hereditary hemolytic anemia is not documented or identified. Do not use this code for hemolytic anemia of the newborn (P55.-).

Medical necessity is established by the presence of signs and symptoms of hemolytic anemia, along with laboratory and genetic test results that confirm the diagnosis of a hereditary hemolytic anemia not otherwise specified. The documentation should support the need for treatment and management of the condition.

Clinicians diagnose the condition through patient history, physical examination, and laboratory tests such as complete blood count (CBC), reticulocyte count, hemoglobin, bilirubin, and liver function tests. Treatment varies depending on the severity and may include corticosteroids, blood transfusions, bone marrow transplants, or splenectomy.

In simple words: This code refers to inherited blood conditions where red blood cells are destroyed prematurely, leading to anemia and symptoms like fatigue, weakness, and shortness of breath. It's used when the specific type of inherited hemolytic anemia isn't known or documented.

Other hereditary hemolytic anemias refers to a genetic blood disorder that leads to the destruction of red blood cells (RBCs). This results in a decreased number of red blood cells and a lack of oxygen in the blood.This code is used when other specific hereditary hemolytic anemias are not documented.

Example 1: A patient presents with fatigue, shortness of breath, and jaundice. Blood tests reveal anemia, elevated bilirubin, and abnormal red blood cell morphology. After ruling out other causes, genetic testing confirms a hereditary hemolytic anemia not otherwise specified., A patient with a family history of hemolytic anemia experiences worsening fatigue and pallor. Laboratory findings indicate anemia and increased red blood cell destruction, leading to a diagnosis of hereditary hemolytic anemia, unspecified type., An infant exhibits signs of anemia, including pallor and lethargy.Initial tests suggest a hemolytic process, and further investigation reveals a genetic defect affecting red blood cell structure. The specific type of hereditary hemolytic anemia is not identified, so D58 is used.

Documentation should include the patient's symptoms, family history, physical exam findings, and laboratory results (CBC, reticulocyte count, bilirubin, hemoglobin, and liver function tests). Genetic testing results confirming the diagnosis are also crucial. If specific tests for other hereditary hemolytic anemias were performed and were negative, this should be documented as well.

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