ICD-10 Coding for Polycythaemia(D45, D75.0, D75.1)
Complete ICD-10-CM coding and documentation guide for Polycythaemia. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Polycythaemia
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| D45 | Polycythemia vera | Use when polycythemia vera is confirmed by WHO criteria. |
|
| D75.0 | Familial erythrocytosis | Use when familial erythrocytosis is confirmed by genetic testing. |
|
| D75.1 | Secondary polycythemia | Use when polycythemia is due to secondary causes. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for polycythemia vera
Essential facts and insights about Polycythaemia
Primary ICD-10-CM Codes for polycythaemia
Decision Criteria
clinical Criteria
- JAK2 mutation and elevated hematocrit
documentation Criteria
- Bone marrow biopsy showing trilineage hyperplasia
Applicable To
- Primary polycythemia
Clinical Validation Requirements
- JAK2 mutation
- Elevated hematocrit/hemoglobin
- Bone marrow biopsy showing trilineage hyperplasia
Code-Specific Risks
- Misclassification if JAK2 mutation is not confirmed
Coding Notes
- Ensure documentation includes JAK2 status and bone marrow findings.
D75.0 - Familial erythrocytosis
Use when familial erythrocytosis is confirmed by genetic testing.
Applicable To
- Familial polycythemia
Excludes
- Polycythemia vera (D45)
Clinical Validation Requirements
- EPOR mutation
- Normal EPO levels
- Family history
Coding Notes
Document genetic test results confirming EPOR mutation.
D75.1 - Secondary polycythemia
Use when polycythemia is due to secondary causes.
Applicable To
- Reactive erythrocytosis
Excludes
- Polycythemia vera (D45)
Clinical Validation Requirements
- History of smoking, COPD, or high-altitude living
- Normal or elevated EPO levels
Coding Notes
Ensure documentation includes secondary cause like smoking or high-altitude exposure.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Polycythaemia to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code D45.
Impact
Clinical: Misdiagnosis of polycythemia type., Regulatory: Non-compliance with coding guidelines., Financial: Potential for incorrect billing and reimbursement.
Mitigation Strategy
Thorough patient history review, Document all potential secondary causes
Impact
Reimbursement: Incorrect DRG assignment may occur., Compliance: Potential for audit and recoupment., Data Quality: Inaccurate data on polycythemia prevalence.
Mitigation Strategy
Query provider for clarification or use D75.1 if secondary causes are suspected.
Impact
High risk of audit if D45 is used without documented JAK2 mutation.
Mitigation Strategy
Ensure JAK2 mutation is documented before coding D45.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Polycythaemia, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Polycythaemia
Use these documentation templates to ensure complete and accurate documentation for Polycythaemia. These templates include all required elements for proper coding and billing.
Hematology consult for suspected polycythemia
Specialty: HematologyRequired Elements
- JAK2 mutation status
- Hematocrit levels
- Bone marrow biopsy findings
- EPO levels
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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