ICD-10 Coding for Polycythemia(D45, D75.1)
Complete ICD-10-CM coding and documentation guide for Polycythemia. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Polycythemia
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 clinical and laboratory findings. |
|
| D75.1 | Secondary polycythemia | Use when polycythemia is secondary to another condition such as hypoxia or tumors. |
|
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 Polycythemia
Primary ICD-10-CM Codes for polycythemia
Decision Criteria
clinical Criteria
- JAK2 V617F mutation positive
documentation Criteria
- Documented low serum EPO
D75.1 - Secondary polycythemia
Use when polycythemia is secondary to another condition such as hypoxia or tumors.
Applicable To
- Polycythemia due to hypoxia
- Polycythemia due to renal tumors
Excludes
- Polycythemia vera (D45)
Clinical Validation Requirements
- Elevated EPO
- Absence of JAK2 mutation
Coding Notes
Document the underlying cause of secondary polycythemia.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Chronic myeloproliferative disease
D47.1Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Polycythemia 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 documentation standards., Financial: Potential for incorrect billing and reimbursement.
Mitigation Strategy
Ensure JAK2 testing is part of diagnostic workup., Include mutation status in documentation.
Impact
Reimbursement: Incorrect reimbursement due to misclassification., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Ensure JAK2 testing is documented before coding D45.
Impact
Risk of incorrect coding due to lack of specific documentation.
Mitigation Strategy
Implement thorough documentation practices and regular audits.
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 Polycythemia, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Polycythemia
Use these documentation templates to ensure complete and accurate documentation for Polycythemia. These templates include all required elements for proper coding and billing.
Polycythemia vera diagnosis
Specialty: HematologyRequired Elements
- Patient symptoms
- JAK2 mutation status
- EPO levels
- Hematocrit and hemoglobin levels
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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