2026 ICD-10-CM Diagnosis Code D58.0Hereditary spherocytosis
ICD-10-CM Codes›D50–D89›D55-D59›D58
- Billable — Valid for Submission
- Chronic Condition
D58.0 is a billable ICD-10-CM diagnosis code for hereditary spherocytosis. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 811 through 812. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Hemolytic anemia.
D58.0 no longer risk-adjusts for Medicare Advantage: it mapped to HCC 48 under the retired CMS-HCC V24 model through payment year 2025 but maps to no category in the live V28 model. It still risk-adjusts in the PACE (CMS-HCC V22) category 48, ESRD (V21) category 48, and ESRD (V24) category 48 for payment year 2026.
Code Identity
Code Classification
Medicare Risk Adjustment (HCC)Billing
D58.0 no longer risk-adjusts for Medicare Advantage: it maps to no payment category in the live CMS-HCC V28 model, although it still risk-adjusts in the other CMS models shown below.
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.
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Hereditary spherocytosis
- Hereditary spherocytosis due to beta spectrin defect
- Hereditary spherocytosis due to combined deficiency of spectrin AND ankyrin
- Hereditary spherocytosis due to deficiency of protein 4.2
- Hereditary spherocytosis due to spectrin deficiency
- Mild hereditary spherocytosis due to combined deficiency of spectrin AND ankyrin
- Mild hereditary spherocytosis due to spectrin deficiency
- Severe hereditary spherocytosis due to combined deficiency of spectrin AND ankyrin
- Severe hereditary spherocytosis due to spectrin deficiency
- Spherocytosis
Tabular List NotesGuidance
Coding notes and annotation back-references applicable to this code.
Inclusion Terms
- Acholuric (familial) jaundice
- Congenital (spherocytic) hemolytic icterus
- Minkowski-Chauffard syndrome
These terms are the conditions for which that code is to be used. The terms may be synonyms of the code title, or, in the case of "other specified" codes, the terms are a list of the various conditions assigned to that code. The inclusion terms are not necessarily exhaustive. Additional terms found only in the Alphabetic Index may also be assigned to a code.
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
Anemia (essential) (general) (hemoglobin deficiency) (infantile) (primary) (profound) D64.9
spherocytic D58.0
Disease, diseased See Also: Syndrome;
Syndrome See Also: Disease;
Minkowski-Chauffard D58.0
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Clinical InformationClinical
Hereditary Spherocytosis
an autosomal dominant inherited disorder characterized by the presence of smaller than normal, sphere-shaped erythrocytes. it results in hemolytic anemia and splenomegaly.Spherocytosis
a hereditary or acquired blood disorder characterized by the presence of smaller than normal, sphere-shaped erythrocytes. it results in hemolytic anemia and splenomegaly.
Patient EducationClinical
Anemia
If you have anemia, your blood does not carry enough oxygen to the rest of your body. The most common cause of anemia is not having enough iron. Your body needs iron to make hemoglobin. Hemoglobin is an iron-rich protein that gives the red color to blood. It carries oxygen from the lungs to the rest of the body.
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert D58.0 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About D58.0Overview
What is the ICD-10 code for hereditary spherocytosis?
The ICD-10-CM code for hereditary spherocytosis is D58.0 (sometimes written as D580). It is billable on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
Is D58.0 (Other hereditary hemolytic anemias) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report hereditary spherocytosis on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
What MS-DRG does D58.0 group to?
When hereditary spherocytosis is the principal diagnosis on an inpatient stay, it groups to MS-DRG 811, 812, with relative weights from 0.9182 to 1.4043 depending on complications. Higher weights mean higher Medicare reimbursement.
What is the ICD-9 equivalent of D58.0?
Under the General Equivalence Mappings, hereditary spherocytosis converts to ICD-9-CM 282.0 (hereditary spherocytosis). The mapping is a direct match.
Does D58.0 risk-adjust for Medicare Advantage payment?
Not for Medicare Advantage. D58.0 mapped to HCC 48 in the retired CMS-HCC V24 model, which last determined payment in 2025, but it maps to no category in the live V28 model; see all codes that no longer risk-adjust. It still risk-adjusts in the PACE (CMS-HCC V22) category 48 (Coagulation Defects and Other Specified Hematological Disorders), ESRD (V21) category 48 (Coagulation Defects and Other Specified Hematological Disorders), and ESRD (V24) category 48 (Coagulation Defects and Other Specified Hematological Disorders).
