2027 ICD-10-CM Diagnosis Code D59.4Other nonautoimmune hemolytic anemias
ICD-10-CM Codes›D50–D89›D55-D59›D59
- Billable — Valid for Submission
- CC — Complication or Comorbidity
- Risk Adjusts — HCC 109
- Not Chronic
D59.4 is a billable ICD-10-CM diagnosis code for other nonautoimmune hemolytic anemias. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 791, 793, 808 through 810. 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 110 closely related codes. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Hemolytic anemia.
For Medicare Advantage risk adjustment, D59.4 maps to CMS-HCC Category 109 (Acquired Hemolytic, Aplastic, and Sideroblastic Anemias) under the V28 model, adding a risk factor of about 1.144 for a community, non-dual, aged beneficiary in payment year 2027.
Code Identity
Code Classification
Medicare Risk Adjustment (HCC)Billing
D59.4 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 2027.
Source: CMS Payment Year 2027 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.
- Anemia caused by oxygen
- Anemia due to mechanical damage
- Anemia following surgical procedure
- Babesiosis
- Disease caused by Babesiidae
- Hematologic complication of procedure
- Hemolytic anemia caused by Bartonella
- Hemolytic anemia caused by Clostridium welchii
- Hemolytic anemia caused by hyperbaric oxygen
- Hemolytic anemia due to babesiosis
- Hemolytic anemia due to infection
- Hemolytic anemia due to malaria
- Infection caused by Clostridium perfringens
- Intracorpuscular hemolytic anemia
- Intraerythrocytic parasitosis by Nuttallia
- Mechanical hemolysis following insertion of prosthetic heart valve
- Mechanical hemolytic anemia
- Microangiopathic hemolytic anemia
- Non-autoimmune hemolytic anemia
- Polyagglutinable erythrocyte syndrome
- Toxic hemolytic anemia
- Traumatic cardiac hemolytic anemia
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to D59.4: its own notes plus those printed at Chapter 3. A note printed at a category, block or chapter applies to every code under it.
Applicable To
Conditions this code is used for: synonyms of the title or, for "other specified" codes, the conditions assigned to it. The list is not exhaustive.
- Mechanical hemolytic anemia
- Microangiopathic hemolytic anemia
- Toxic hemolytic anemia
Excludes2
Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.
- autoimmune disease (systemic) NOS (M35.9)
- certain conditions originating in the perinatal period (P00-P96)
- complications of pregnancy, childbirth and the puerperium (O00-O9A)
- congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)
- endocrine, nutritional and metabolic diseases (E00-E88)
- human immunodeficiency virus [HIV] disease (B20)
- injury, poisoning and certain other consequences of external causes (S00-T88)
- neoplasms (C00-D49)
- symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
Source: CMS ICD-10-CM Tabular List. How to read instructional notes.
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
Anemia (essential) (general) (hemoglobin deficiency) (infantile) (primary) (profound) D64.9
infectious D59.4
toxic D59.4
mechanical D59.4
microangiopathic D59.4
nonautoimmune D59.4
secondary D59.4
symptomatic D59.4
toxic D59.4
Disease, diseased See Also: Syndrome;
nonautoimmune hemolytic D59.4
Syndrome See Also: Disease;
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Clinical InformationClinical
Acquired Hemolytic Anemia
hemolytic anemia, the cause of which is not present at birth.
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 D59.4 to ICD-9-CMHistory
Code HistoryHistory
Questions About D59.4Overview
What is the ICD-10 code for other nonautoimmune hemolytic anemias?
The ICD-10-CM code for other nonautoimmune hemolytic anemias is D59.4 (sometimes written as D594). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is D59.4 (Acquired hemolytic anemia) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report other nonautoimmune hemolytic anemias on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does D59.4 group to?
When other nonautoimmune hemolytic anemias is the principal diagnosis on an inpatient stay, it groups to MS-DRG 793, 791, 808, 809, 810, with relative weights from 1.0749 to 4.2192 depending on complications. Higher weights mean higher Medicare reimbursement.
Is D59.4 a CC or MCC?
CMS lists D59.4 as a CC (complication or comorbidity) for FY 2027. 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 110 closely related codes in its exclusion list.
What is the ICD-9 equivalent of D59.4?
Under the General Equivalence Mappings, other nonautoimmune hemolytic anemias converts to ICD-9-CM 283.10 (nonauto hem anemia NOS) and 283.19 (oth nonauto hem anemia). The mapping is approximate, so confirm the match fits the documentation.
What HCC is D59.4?
D59.4 (other nonautoimmune hemolytic anemias) maps to CMS-HCC Category 109 (Acquired Hemolytic, Aplastic, and Sideroblastic Anemias), commonly written as HCC 109, in the CMS-HCC V28 model used for Medicare Advantage risk adjustment in payment year 2027. 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. In the Part D prescription drug model it maps to RxHCC 96.
Does D59.4 risk-adjust for Medicare Advantage payment?
Yes. When documented and reported on a Medicare Advantage encounter, D59.4 adds a risk adjustment factor of about 1.144 to the beneficiary's RAF score for a community, non-dual, aged enrollee (published V28 weights range from 0.529 to 1.815 depending on the payment segment). HCC 109 sits at the top of its hierarchy, so no other condition category supersedes it. See the full factor table on the HCC 109 category page.
