2025 ICD-10-CM code D56
Thalassemia is a genetic blood disorder characterized by a reduced amount of hemoglobin and red blood cells, leading to anemia.
Medical necessity for thalassemia treatment is established by the presence of anemia, its severity, and related complications. Regular blood transfusions are medically necessary for patients with thalassemia major to maintain adequate hemoglobin levels and prevent complications like organ damage. Iron chelation therapy is necessary to remove excess iron from frequent transfusions, preventing iron overload and its associated health risks.
Diagnosis and management of thalassemia involves a comprehensive approach including patient history, physical examination, and laboratory tests like complete blood count (CBC) and hemoglobin electrophoresis. Treatment varies depending on the type and severity, ranging from iron supplementation and dietary changes to regular blood transfusions, iron chelation therapy, and potentially bone marrow transplantation.
- Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism (D50-D89)
- Hemolytic anemias
In simple words: Thalassemia is a genetic blood disorder that leads to lower-than-normal levels of hemoglobin, the protein in red blood cells that carries oxygen. This can cause you to feel tired and weak because your body isn't getting enough oxygen.There are different types of thalassemia, some mild and some more serious, requiring regular blood transfusions.
Thalassemia is an inherited blood disorder characterized by a reduced production of normal hemoglobin, the protein in red blood cells that carries oxygen throughout the body. This reduced hemoglobin production leads to a decreased number of healthy red blood cells and can cause mild to severe anemia, depending on the type and severity of the thalassemia. There are two main types of thalassemia: alpha-thalassemia and beta-thalassemia. The severity of alpha-thalassemia depends on the number of gene mutations inherited, while the severity of beta-thalassemia depends on which part of the hemoglobin molecule is affected.
Example 1: A 6-month-old infant presents with pallor, fatigue, and poor feeding. Blood tests reveal low hemoglobin and small, pale red blood cells. Hemoglobin electrophoresis confirms the diagnosis of beta-thalassemia major., A 25-year-old pregnant woman of Mediterranean descent undergoes routine prenatal blood tests, which reveal mild anemia and microcytic red blood cells. Further testing diagnoses her with beta-thalassemia minor, and genetic counseling is recommended., A 40-year-old individual of Southeast Asian heritage experiences fatigue, shortness of breath, and jaundice. They are found to have an enlarged spleen and abnormal hemoglobin levels, leading to a diagnosis of Hemoglobin H disease, a type of alpha-thalassemia.
Documentation for thalassemia should include complete blood count (CBC) results, hemoglobin electrophoresis findings, genetic testing results (if performed), iron studies, and a detailed clinical history including symptoms, family history, and ethnicity.Any complications, such as splenomegaly or bone deformities, should also be documented.
- Specialties:Hematology, Oncology, Pediatrics, Internal Medicine, Family Medicine
- Place of Service:Inpatient Hospital, On Campus-Outpatient Hospital, Physician's Office, Independent Clinic, Federally Qualified Health Center