Polycythemia Vera ICD 10 Code

Refresher: What are ICD-10 codes?

The International Classification of Diseases, 10th revision (ICD-10) is a cataloging system that is used for tracking medical conditions [1]. The ICD-10-CM is a clinically modified version of the ICD-10, authorized by the WHO, and is specifically used in US healthcare organizations [2]. This system consists of over 68,000 codes compared to just around 13,000 codes for ICD-9-CM [3].

The ICD-10-CM classification system provides more diagnostic specificity needed to improve the quality of care, allowing the data to be used in a more meaningful way and creating more robust clinical algorithms. The greater specificity and accuracy of ICD-10-CM codes allow healthcare professionals to make more informed decisions and improve their research outcomes.

There are various differences between the ICD-10-CM and ICD-9-CM in terms of code composition, level of detail, and organization. Below is an example of codes used in the ICD-10-CM cataloging system:

• A00 through B99 are used for infectious and parasitic diseases
• C00 through D49 are used for neoplasms
• D50 through D89 are used for diseases of the blood and disorders involving the immune mechanism
• H00 through H59 are used for disease of the eye and adnexa
• P00 through P96 are used for medical conditions in the perinatal period
• Z00 through Z99 are used for factors influencing health status and contact with health services

You may have also come across the ICD-10-PCS cataloging system. It stands for procedural classification system and was developed with the support of the Centers for Medicare and Medicaid Services. The ICD-10-PCS system has about 87,000 codes and is applicable for inpatient hospital settings in US healthcare organizations [4].

What is the ICD 10 code for Polycythemia vera?

For polycythemia vera, the general ICD-10 code is D45 (chronic myeloproliferative neoplasm). It excludes familial polycythemia (D75.0) and secondary polycythemia (D75.0). The medical condition is characterized by a chronic myeloproliferative neoplasm with increased production of red blood cells. The main symptoms of polycythemia vera are very similar to hypertension and vascular abnormalities, making it difficult to diagnose the disorder.

Polycythemia vera ICD 10 code: D45-

Polycythemia vera ICD code D45- lookup

The ICD 10 polycythemia code for chronic myeloproliferative neoplasm is D45- [5]. There are no other ICD-10 codes for polycythemia vera. It excludes familial polycythemia and secondary polycythemia.

Polycythemia vera is a relatively rare medical condition, with an estimated 22 in 100,000 people being diagnosed [6]. More men than women are affected by the disorder. The chronic disorder is characterized by the overproduction of blood cells in the bone marrow. There is a high production of white blood cells and platelets in most cases.

As a consequence, the patient's blood thickens and increases in volume, a condition known as hyperviscosity. Thickened blood may not be able to flow through small blood vessels properly. Some of the symptoms of polycythemia vera include weakness, dizziness, itchy skin, gastrointestinal issues, and blood clot formation. In addition to these, blood flow may be restricted to vital organs.

The life expectancy for patients who have been diagnosed with polycythemia vera after diagnosis is 20 years. The average age of death for patients is 77, with the most common cause of fatalities being complications from blood clots [7].

Diagnosing polycythemia vera requires taking a small sample of the bone marrow through a bone marrow aspiration or biopsy. The main criteria for diagnosis of polycythemia vera are as follows:

• Hemoglobin >18.5 g/dL in men and 16.5 g/dL in women
• A mutation such as JAK2V617F or JAK2 exon 12

Note that there is no cure for polycythemia vera. Treatments are aimed at managing the symptoms of polycythemia vera. The most common treatment is to have frequent blood withdrawals using a procedure known as phlebotomy. This is the same procedure used for donating blood.

This can decrease blood volume and reduce the number of excess blood cells. The frequency of blood withdrawal depends on how severe the condition is.

Itching can be a major inconvenience to patients and can affect the quality of life outcomes. Itching can be treated with the help of antihistamines and other medications that are used for treating depression, such as SSRIs. Doctors may also recommend the use of ultraviolet light treatment to relieve any discomfort.

If blood withdrawals are not enough to reduce the number of blood vessels, doctors may recommend medications that reduce the number of red blood cells in the bloodstream. The most commonly prescribed medications include:

• Interferon
• Ruxolitinib
• Busulfan
• Hydroxyurea

Finally, the patient may be asked to make certain lifestyle changes such as exercise, avoiding tobacco, avoiding high altitude areas (or any environment that has low oxygen levels), and implementing a good skincare routine.

Types of Polycythemia vera coded under D45-

The ICD 10 code D45- does not specify the subtype of polycythemia vera. A D45 code can be used for polycythemia vera of various types, as will be discussed below:

• Chronic erythremia in relapse
• Leukemia, erythremia, chronic, in remission
• Polycythemia vera (clinical)
• Polycythemia vera in relapse
• Polycythemia vera in remission

In other words, leukemia, erythremia, chronic, in remission ICD 10, polycythemia vera (clinical) ICD 10, and polycythemia vera in remission ICD 10 codes could all be D45 if they are determined to be chronic myeloproliferative neoplasm with an increased production of red blood cells. As a concrete example, a patient diagnosed with leukemia, erythremia, chronic, in remission, would be coded with D45.

There are both advantages and disadvantages of upgrading to the ICD-10. The disadvantages are usually short-lived and are often associated with a lack of experience and budget. The main advantages are the increased specificity of the classification system that allows for more accurate diagnostics, consistent record keeping, and improved patient care.

It is worth noting that medical coders often have to work with large data sets requiring access to expensive infrastructure. Failing to know how to navigate these systems can easily result in identifying an incorrect code. The consequences of identifying an incorrect code can have a negative impact on patient outcomes. Namely, patients may be exposed to the side effects of an incorrect medication while their actual medical condition goes untreated and worsens with time.

Upgrading to the ICD-10 requires an investment of both time and money. Service providers that help healthcare organizations upgrade to ICD-10 often charge a premium. Not to mention the fact that while the systems are being updated, the healthcare organization may go through a slump in productivity that could affect patient outcomes and reduce revenues.

Healthcare organizations with smaller budgets may struggle to allocate the appropriate funds for upgrading to ICD-10.

All these problems are short-lived, and peak productivity levels should resume once the systems have been properly updated. It should also be noted that healthcare professionals and medical coders may be required to undertake additional examinations in order to accurately use the ICD-10-CM classification system.

This means attending more classes and seminars that require time and money. For many professionals, taking exams to obtain appropriate certifications can be very expensive and may be inconvenient to them.

Polycythemia vera excluded from ICD-10 D45

The ICD-10 D45 code does not include familial polycythemia and secondary polycythemia. Familial polycythemia is an inherited medical condition that causes an increased production of red blood cells. Secondary polycythemia is a medical condition that involves the overproduction of red blood cells due to genetic abnormalities.

Although they may appear to be similar, polycythemia vera is different from secondary polycythemia. The former is characterized by a bone marrow with an increased proliferative activity, while the latter is defined as an absolute increase in red blood cell production due to enhanced simulation for red blood cell production.

As such, the following synonyms of secondary polycythemia are excluded from D45 [8]:

• Acquired polycythemia
• Emotional polycythemia
• Erythrocytosis NOS
• Hypoxemic polycythemia
• Nephrogenous polycythemia
• Polycythemia due to erythropoietin
• Polycythemia due to a fall in plasma volume
• Polycythemia due to high altitude
• Polycythemia due to stress
• Polycythemia NOS
• Relative polycythemia

And the following synonyms of familial polycythemia are excluded from D45 [9]:

• Benign polycythemia
• Familial polycythemia
• Familial polycythemia vera
• Polycythemia vera, familial

Conclusion

The ICD-10 code for polycythemia vera is D45 and is applicable to Chronic erythremia in relapse, Leukemia, erythremia, chronic, in remission, and Polycythemia vera (clinical), among others. Common symptoms of polycythemia vera include shortness of breath, dizziness, inability to concentrate, headache, and fatigue, among others.

The medical condition has no cure, but timely intervention can help patients manage symptoms and any risks of complications. Note that the ICD-10 codes discussed in this article are meant to be used for reference purposes only and do not replace professional medical advice.

If you believe you have polycythemia vera, you should visit a medical professional at the earliest for an accurate diagnosis. You should also direct any questions you have about polycythemia vera and its ICD-10 code to the healthcare professional.