D56.8 vs D57
D56.8 and D57 can never be reported together. ICD-10-CM declares them mutually exclusive with an Excludes1 note, meaning the two conditions cannot occur in the same patient — so exactly one of them is correct for any given encounter.
The official note, declared on D56.8
sickle-cell anemia (D57.-)
D56.8
Other thalassemias
Billable
- Chapter 3
- Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism
- Section
- D55-D59
Use when the record says
- Dominant thalassemia
- Hemoglobin C thalassemia
- Mixed thalassemia
- Thalassemia with other hemoglobinopathy
Indexed under
- Variants, thalassemic
- Hemoglobinopathy › with thalassemia (mixed)
- Thalassemia › with other hemoglobinopathy (anemia) (disease)
- Thalassemia › dominant (anemia) (disease)
- Thalassemia › mixed (anemia) (disease)
D57
Sickle-cell disorders
Not billable
- Chapter 3
- Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism
- Section
- D55-D59
Indexed under
- Arthropathy › gouty › in › sickle-cell disorders
Excludes1 is not always absolute: where two conditions covered by the note are genuinely unrelated, CMS guidance permits reporting both. Document the reasoning rather than assuming it. More on Excludes1 vs Excludes2 · FY2027