2026 ICD-10-CM Diagnosis Code D57.454Sickle-cell thalassemia beta plus with dactylitis

ICD-10-CM Codes›D50–D89›D55-D59›D57

ICD-10-CM D57.454
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

D57.454 is a billable ICD-10-CM diagnosis code for sickle-cell thalassemia beta plus with dactylitis. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 791, 793, 811 through 812. As a secondary diagnosis, it counts as a major complication or comorbidity (MCC) and places an inpatient stay in the highest severity level of its MS-DRG family. It does not count, however, when the principal diagnosis is one of 51 closely related codes. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Sickle cell trait/anemia.

For Medicare Advantage risk adjustment, D57.454 maps to CMS-HCC Category 108 (Sickle Cell Disorders, Except Sickle Cell Anemia (Hb-SS) and Thalassemia Beta Zero; Beta Thalassemia Major) under the V28 model, adding a risk factor of about 0.146 for a community, non-dual, aged beneficiary in payment year 2026.

Code Identity

ICD-10-CM Code
D57.454
Billable Status
Yes — Valid for Submission
Code Describes
Sickle-cell thalassemia beta plus with dactylitis
Short Description
Sickle-cell thalassemia beta plus with dactylitis
Same as the full description in the CMS dataset.
Parent Code
D57.45
Sickle-cell thalassemia beta plus with crisis

Code Classification

ChapterD50–D89Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism
SectionD55-D59Hemolytic anemias
CategoryD57Sickle-cell disorders
This CodeD57.454Sickle-cell thalassemia beta plus with dactylitis

Medicare Risk Adjustment (HCC)Billing

D57.454 maps to a payment category in the CMS-HCC model used to risk-adjust Medicare Advantage payments. Weights are the published community factors for payment year 2026.

CMS-HCC V28 Category (Payment Model)
HCC 108— Sickle Cell Disorders, Except Sickle Cell Anemia (Hb-SS) and Thalassemia Beta Zero; Beta Thalassemia Major
Payment HCC · PY 2026 one of 39 ICD-10-CM codes in this category
Risk Adjustment Factor (RAF) Weight
+0.146
community, non-dual, aged · ranges 0.098–0.416 across segments
Hierarchy
Superseded by HCC 107
a more severe related category takes the payment when both are reported
Prior Model (CMS-HCC V24)
HCC 46
V24 retired V28 pays 100% of MA risk scores since PY 2026
Other CMS Models
PACE (CMS-HCC V22): HCC 46 · ESRD (V21): HCC 46 · ESRD (V24): HCC 46
ESRD V21 weights: 0.180 dialysis, 0.766–1.325 functioning graft · ESRD V24 weights: 0.223 dialysis, 0.748–4.064 functioning graft
Part D (RxHCC)
Not mapped
D57.454 does not risk-adjust in the RxHCC prescription drug model

Source: CMS Payment Year 2026 risk adjustment mappings and model software. Weights are relative factors, not dollar amounts; a beneficiary's total RAF also includes demographics and interactions. Browse all CMS-HCC categories.

Index to Diseases and InjuriesGuidance

Alphabetical index entries that point to this code.

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR BLD005
Sickle cell trait/anemia
Default principal diagnosis: inpatient Yes · outpatient Yes

Code History & ChangesHistory

Replacement D57.454 replaces the following previously assigned code(s):

  • D57.458 - Sickle-cell thalassemia beta plus with crisis with oth comp
FY 2024AddedAdded to the ICD-10-CM code setEffective October 1, 2023.
FY 2025No changes
FY 2026CurrentCurrent code set, no changesEffective October 1, 2025 through September 30, 2026.

Questions About D57.454Overview

What is the ICD-10 code for sickle-cell thalassemia beta plus with dactylitis?

The ICD-10-CM code for sickle-cell thalassemia beta plus with dactylitis is D57.454 (sometimes written as D57454). It is billable on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

Is D57.454 (Sickle-cell thalassemia beta plus with crisis) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report sickle-cell thalassemia beta plus with dactylitis on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

What MS-DRG does D57.454 group to?

When sickle-cell thalassemia beta plus with dactylitis is the principal diagnosis on an inpatient stay, it groups to MS-DRG 791, 793, 811, 812, with relative weights from 0.9182 to 4.1696 depending on complications. Higher weights mean higher Medicare reimbursement.

Is D57.454 a CC or MCC?

CMS lists D57.454 as an MCC (major complication or comorbidity) for FY 2026. Reported as a secondary diagnosis, it places the inpatient stay in the highest-weighted DRG of its severity family. It does not count when the principal diagnosis is one of the 51 closely related codes in its exclusion list.

What HCC is D57.454?

D57.454 (sickle-cell thalassemia beta plus with dactylitis) maps to CMS-HCC Category 108 (Sickle Cell Disorders, Except Sickle Cell Anemia (Hb-SS) and Thalassemia Beta Zero; Beta Thalassemia Major), commonly written as HCC 108, in the CMS-HCC V28 model used for Medicare Advantage risk adjustment in payment year 2026. It mapped to HCC 46 under the retired V24 model. It also maps in the PACE (CMS-HCC V22), ESRD (V21), and ESRD (V24) models. It does not map to any RxHCC in the Part D prescription drug model.

Does D57.454 risk-adjust for Medicare Advantage payment?

Yes. When documented and reported on a Medicare Advantage encounter, D57.454 adds a risk adjustment factor of about 0.146 to the beneficiary's RAF score for a community, non-dual, aged enrollee (published V28 weights range from 0.098 to 0.416 depending on the payment segment). A more severe related category (HCC 107) supersedes it when both are reported. See the full factor table on the HCC 108 category page.