ICD-10 D56.2
Billable / Specific HCC v28: 48Delta-beta thalassemia
About ICD-10-CM D56.2
ICD-10-CM code D56.2 represents Delta-beta thalassemia. This is a billable/specific code in the Blood and Blood-forming Organs chapter (block D56). The 2026 edition of ICD-10-CM D56.2 became effective on October 1, 2025.
Coding Tips for D56.2
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
D56.2 is a CMS-HCC v28 risk-adjustment code (category 48). To count for the patient Risk Adjustment Factor (RAF), document the diagnosis with MEAT language each calendar year: Monitored, Evaluated, Assessed, Treated. A diagnosis on the problem list alone does not satisfy CMS RADV audit standards. Include the diagnosis in the assessment with current status and current treatment plan.
Inclusion Terms / Approximate Synonyms
Clinical terms and conditions classified under D56.2. Per CMS ICD-10-CM Tabular 2026.
- Homozygous delta-beta thalassemia
Type 1 Excludes
Pure excludes, these codes can never be coded together with D56.2. The conditions are mutually exclusive (e.g., congenital vs acquired forms).
- delta-beta thalassemia minor (D56.3)
- delta-beta thalassemia trait (D56.3)
Medicare Advantage HCC Impact
Capture this diagnosis annually for accurate risk adjustment. Missed HCC captures are the #1 revenue leak in Medicare Advantage risk programs.
Medicare LCD Coverage for D56.2
Local Coverage Determinations (LCDs) from CMS MACs that list D56.2 as a covered diagnosis.
Showing top 10 of 219 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing D56.2.
5 Medicare
Convert D56.2 to ICD-9-CM
Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.
| ICD-10 | ICD-9 | Mapping Flags |
|---|---|---|
| D56.2 | 28245 | 00000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To D56.2
Other codes in section D55-D59 (Hemolytic anemias).
ICD-10 D56.2, Billing FAQ
Is ICD-10 code D56.2 billable? +
Yes, D56.2 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
What other names or terms map to D56.2? +
ICD-10 D56.2 includes: Homozygous delta-beta thalassemia.
What codes are Type 1 Excludes for D56.2? +
Type 1 Excludes (never code together with D56.2): delta-beta thalassemia minor (D56.3); delta-beta thalassemia trait (D56.3)
Does D56.2 affect Medicare Advantage HCC risk adjustment? +
Yes. D56.2 maps to CMS-HCC v28 category 48. Capture this diagnosis annually for accurate Medicare Advantage risk score.
What CPT codes are commonly billed with D56.2? +
Procedures frequently paired with D56.2 include: J2791, J2792.
What ICD-9 codes does D56.2 map to? +
Per CMS GEMs, D56.2 maps to ICD-9 codes: 28245. Useful for legacy data review and historical claim analysis.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on July 16, 2026.
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