2026 ICD-10-CM Diagnosis Code D58.9Hereditary hemolytic anemia, unspecified

ICD-10-CM Codes›D50–D89›D55-D59›D58

ICD-10-CM D58.9
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

D58.9 is a billable ICD-10-CM diagnosis code for hereditary hemolytic anemia, unspecified. 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. As a secondary diagnosis, it counts as a complication or comorbidity (CC) and moves an inpatient stay to a higher severity level within its MS-DRG family. It does not count, however, when the principal diagnosis is one of 104 closely related codes. Coders also document this condition as associated pulmonary arterial hypertension. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Hemolytic anemia.

D58.9 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

ICD-10-CM Code
D58.9
Billable Status
Yes — Valid for Submission
Code Describes
Hereditary hemolytic anemia, unspecified
Short Description
Hereditary hemolytic anemia, unspecified
Same as the full description in the CMS dataset.
Parent Code
D58
Other hereditary hemolytic anemias

Code Classification

ChapterD50–D89Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism
SectionD55-D59Hemolytic anemias
CategoryD58Other hereditary hemolytic anemias
This CodeD58.9Hereditary hemolytic anemia, unspecified

Medicare Risk Adjustment (HCC)Billing

D58.9 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.

CMS-HCC V28 (Medicare Advantage Payment Model)
Not mapped
Dropped in V28 see all codes that no longer risk-adjust
Prior Model (CMS-HCC V24)
HCC 48
V24 retired last contributed to a Medicare Advantage risk score in payment year 2025
Other CMS Models
PACE (CMS-HCC V22): HCC 48 · ESRD (V21): HCC 48 · ESRD (V24): HCC 48
ESRD V21 weights: 0.059 dialysis, 0.173–0.234 functioning graft · ESRD V24 weights: 0.063 dialysis, 0.192–0.358 functioning graft
Part D (RxHCC)
Not mapped
D58.9 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.

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Associated pulmonary arterial hypertension
  • Chronic hemolytic anemia
  • Congenital hemolytic anemia
  • Hemolytic anemia
  • Hemolytic anemia with emphysema AND cutis laxa
  • Hereditary hemolytic anemia
  • Lethal hemolytic anemia and genital anomaly syndrome
  • Megaloblastic anemia due to chronic hemolytic anemia
  • Pulmonary arterial hypertension associated with chronic hemolytic anemia

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 BLD002
Hemolytic anemia
Default principal diagnosis: inpatient Yes · outpatient Yes

Clinical InformationClinical

  • Acquired Hemolytic Anemia

    hemolytic anemia, the cause of which is not present at birth.

  • Autoimmune Hemolytic Anemia|autoimmune hemolytic anemia

    an acquired anemia caused by destruction of the red blood cells by autoantibodies. causes include autoimmune disorders, lymphoproliferative disorders, and infections.

  • Autosomal Recessive Distal Renal Tubular Acidosis-4 with Hemolytic Anemia|DRTA4

    an autosomal recessive type of distal renal tubular acidosis caused by mutation(s) in the slc4a1 gene, encoding band 3 anion transport protein. additionally, it may be characterized by hemolytic anemia.

  • Grade 1 Hemolysis, CTCAE|CTCAE Grade 1 Hemolysis (e.g., immune hemolytic anemia, drug-related hemolysis)|Grade 1 Hemolysis|Grade 1 Hemolysis (e.g., immune hemolytic anemia, drug-related hemolysis)

    laboratory evidence of hemolysis only (e.g., direct antiglobulin test; dat; coombs'; schistocytes; decreased haptoglobin)

  • Grade 2 Hemolysis, CTCAE|CTCAE Grade 2 Hemolysis (e.g., immune hemolytic anemia, drug-related hemolysis)|Grade 2 Hemolysis|Grade 2 Hemolysis (e.g., immune hemolytic anemia, drug-related hemolysis)

    evidence of hemolysis and >=2 g decrease in hemoglobin

  • Grade 3 Hemolysis, CTCAE|CTCAE Grade 3 Hemolysis (e.g., immune hemolytic anemia, drug-related hemolysis)|Grade 3 Hemolysis|Grade 3 Hemolysis (e.g., immune hemolytic anemia, drug-related hemolysis)

    transfusion or medical intervention indicated (e.g., steroids)

  • Grade 4 Hemolysis, CTCAE|CTCAE Grade 4 Hemolysis (e.g., immune hemolytic anemia, drug-related hemolysis)|Grade 4 Hemolysis|Grade 4 Hemolysis (e.g., immune hemolytic anemia, drug-related hemolysis)

    life-threatening consequences; urgent intervention indicated

  • Grade 5 Hemolysis, CTCAE|CTCAE Grade 5 Hemolysis (e.g., immune hemolytic anemia, drug-related hemolysis)|Grade 5 Hemolysis|Grade 5 Hemolysis (e.g., immune hemolytic anemia, drug-related hemolysis)

    death

  • Hemolysis, CTCAE|Hemolysis|Hemolysis|Hemolysis (e.g., immune hemolytic anemia, drug-related hemolysis)

    a disorder characterized by laboratory test results that indicate widespread erythrocyte cell membrane destruction.

  • Hemolytic Anemia

    anemia resulting from the premature destruction of the peripheral blood red cells. it may be congenital or it may be caused by infections, medications, or malignancies.

  • Hemolytic Anemia due to Membrane Defect|Anemia due to Membrane Defect|Hemolytic Anemia due to Erythrocyte Membrane Defect

    a group of inherited hemolytic anemias caused by erythrocyte membrane defects. this includes hereditary pyropoikilocytosis, hereditary spherocytosis and hereditary elliptocytosis.

  • Hereditary Hemolytic Anemia|Congenital Hemolytic Anemia

    a congenital hemolytic anemia caused by defects of the erythrocyte membrane, enzyme deficiencies, or hemoglobinopathies.

  • Immune Hemolytic Anemia|immune complex hemolytic anemia|immunohemolytic anemia

    an acquired anemia resulting from immune-mediated destruction of the red blood cells. causes include autoimmune disorders, blood transfusions, and drugs.

  • Non-Autoimmune Hemolytic Anemia

    hemolytic anemia that is not mediated by immune mechanisms.

  • Pyruvate Kinase Deficiency|Hemolytic Anemia due to Pyruvate Kinase Deficiency

    an inherited metabolic disorder characterized by the deficiency of the erythrocyte enzyme pyruvate kinase. it results in the development of hemolytic anemia.

  • Warm Antibody Autoimmune Hemolytic Anemia

    the most common form of autoimmune hemolytic anemia, in which the autoantibodies react with red blood cells at temperatures greater than or equal to 37 degrees celsius.

  • Grade 1 Hemolytic Anemia, CTCAE

    <10% drop in hgb from last assessment; intervention not indicated

  • Grade 2 Hemolytic Anemia, CTCAE

    <=2 units of prbcs transfused per day

  • Grade 3 Hemolytic Anemia, CTCAE

    >2 units of prbcs per day indicated

  • Grade 4 Hemolytic Anemia, CTCAE

    life-threatening consequences; urgent intervention indicated

  • Grade 5 Hemolytic Anemia, CTCAE

    death

  • Hemolytic Anemia, CTCAE

    anemia resulting from hemolysis.

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 D58.9 to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
282.9 Hered hemolytic anem NOS
Exact Match The mapping is direct, with no qualifiers.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2025No changes
FY 2026CurrentCurrent code set, no changesEffective October 1, 2025 through September 30, 2026.

Questions About D58.9Overview

What is the ICD-10 code for hereditary hemolytic anemia, unspecified?

The ICD-10-CM code for hereditary hemolytic anemia, unspecified is D58.9 (sometimes written as D589). It is billable on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

Is D58.9 (Other hereditary hemolytic anemias) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report hereditary hemolytic anemia, unspecified on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

What MS-DRG does D58.9 group to?

When hereditary hemolytic anemia, unspecified 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.

Is D58.9 a CC or MCC?

CMS lists D58.9 as a CC (complication or comorbidity) for FY 2026. Reported as a secondary diagnosis, it moves the inpatient stay to a higher-weighted DRG within its severity family. It does not count when the principal diagnosis is one of the 104 closely related codes in its exclusion list.

What is the ICD-9 equivalent of D58.9?

Under the General Equivalence Mappings, hereditary hemolytic anemia, unspecified converts to ICD-9-CM 282.9 (hered hemolytic anem NOS). The mapping is a direct match.

Does D58.9 risk-adjust for Medicare Advantage payment?

Not for Medicare Advantage. D58.9 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).