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ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 D58.2

Billable / Specific HCC v28: 48

Other hemoglobinopathies

D58
Block
7
Synonyms
54
LCDs
10
Payer Policies
0
Linked CPTs

About ICD-10-CM D58.2

ICD-10-CM code D58.2 represents Other hemoglobinopathies. This is a billable/specific code in the Blood and Blood-forming Organs chapter (block D58). The 2026 edition of ICD-10-CM D58.2 became effective on October 1, 2025.

Coding Tips for D58.2

Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.

HCC capture: document with MEAT each year

D58.2 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 D58.2. Per CMS ICD-10-CM Tabular 2026.

  • Abnormal hemoglobin NOS
  • Congenital Heinz body anemia
  • Hb-C disease
  • Hb-D disease
  • Hb-E disease
  • Hemoglobinopathy NOS
  • Unstable hemoglobin hemolytic disease

Type 1 Excludes

Pure excludes, these codes can never be coded together with D58.2. The conditions are mutually exclusive (e.g., congenital vs acquired forms).

  • familial polycythemia (D75.0)
  • Hb-M disease (D74.0)
  • hemoglobin E-beta thalassemia (D56.5)
  • hereditary persistence of fetal hemoglobin [HPFH] (D56.4)
  • high-altitude polycythemia (D75.1)
  • methemoglobinemia (D74.-)
  • other hemoglobinopathies with thalassemia (D56.8)

Medicare Advantage HCC Impact

CMS-HCC v28 (current)
Category 48
ESRD-HCC
Category 48
RxHCC (Part D)
Category 48

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 D58.2

Local Coverage Determinations (LCDs) from CMS MACs that list D58.2 as a covered diagnosis.

54 LCDs

Showing top 10 of 54 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Lab: Flow Cytometry
Article ID: 57689, Effective: 2025-11-06 00:00:00, 1518 covered, 0 non-covered
CPT 88189 →
CMS LCD: Billing and Coding: Lab: Flow Cytometry
Article ID: 57689, Effective: 2025-11-06 00:00:00, 1518 covered, 0 non-covered
CPT 86360 →
CMS LCD: Billing and Coding: Lab: Flow Cytometry
Article ID: 57689, Effective: 2025-11-06 00:00:00, 1518 covered, 0 non-covered
CPT 86361 →
CMS LCD: Billing and Coding: Lab: Flow Cytometry
Article ID: 57689, Effective: 2025-11-06 00:00:00, 1518 covered, 0 non-covered
CPT 88187 →
CMS LCD: Billing and Coding: Lab: Flow Cytometry
Article ID: 57689, Effective: 2025-11-06 00:00:00, 1518 covered, 0 non-covered
CPT 86363 →
CMS LCD: Billing and Coding: Lab: Flow Cytometry
Article ID: 57689, Effective: 2025-11-06 00:00:00, 1518 covered, 0 non-covered
CPT 86359 →
CMS LCD: Billing and Coding: Lab: Flow Cytometry
Article ID: 57689, Effective: 2025-11-06 00:00:00, 1518 covered, 0 non-covered
CPT 86356 →
CMS LCD: Billing and Coding: Lab: Flow Cytometry
Article ID: 57689, Effective: 2025-11-06 00:00:00, 1518 covered, 0 non-covered
CPT 88188 →
CMS LCD: Billing and Coding: Lab: Flow Cytometry
Article ID: 57689, Effective: 2025-11-06 00:00:00, 1518 covered, 0 non-covered
CPT 88184 →
CMS LCD: Billing and Coding: Lab: Flow Cytometry
Article ID: 57689, Effective: 2025-11-06 00:00:00, 1518 covered, 0 non-covered
CPT 88185 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing D58.2.

10 policies

3 Aetna

Oxygen - Medical Clinical Policy Bulletins | Aetna
Policy ID: CPB-0002
Genetic Testing
Policy ID: CPB-0140
Flow Cytometry, Ektacytometry, DNA Ploidy, and S-phase Fraction
Policy ID: CPB-0351

3 Cigna

Flow Cytometry - (0538)
Policy ID: MM_0538
Serum Folate and Red Blood Cell Folate Testing - (0567)
Policy ID: MM_0567
Transthoracic Echocardiography in Children - (0523)
Policy ID: MM_0523

4 Medicare

Billing and Coding: Lab: Flow Cytometry
Policy ID: ART-55717
Billing and Coding: Flow Cytometry
Policy ID: ART-56464
Billing and Coding: Intravenous Immunoglobulin (IVIG)
Policy ID: ART-56718
Billing and Coding: Lab: Flow Cytometry
Policy ID: ART-57689

CPT Codes Commonly Billed with D58.2

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

No procedure linkages on file for D58.2

We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.

Convert D58.2 to ICD-9-CM

Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.

ICD-10ICD-9Mapping Flags
D58.2 2827 10000

Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).

ICD-10 D58.2, Billing FAQ

Is ICD-10 code D58.2 billable? +

Yes, D58.2 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 D58.2? +

ICD-10 D58.2 includes: Abnormal hemoglobin NOS; Congenital Heinz body anemia; Hb-C disease, and 4 more clinical synonyms.

What codes are Type 1 Excludes for D58.2? +

Type 1 Excludes (never code together with D58.2): familial polycythemia (D75.0); Hb-M disease (D74.0); hemoglobin E-beta thalassemia (D56.5)

Does D58.2 affect Medicare Advantage HCC risk adjustment? +

Yes. D58.2 maps to CMS-HCC v28 category 48. Capture this diagnosis annually for accurate Medicare Advantage risk score.

What ICD-9 codes does D58.2 map to? +

Per CMS GEMs, D58.2 maps to ICD-9 codes: 2827. 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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