D45

HCC Category Mapping

What This Code Means

Polycythemia vera is a blood disorder where the bone marrow produces too many red blood cells, causing the blood to become thick and potentially leading to blood clots or bleeding problems. This is a chronic condition that requires ongoing monitoring and treatment.

Coding Tips

• •D45 is the only code needed for polycythemia vera diagnosis; do not add additional codes for secondary polycythemia (D75.1) unless explicitly documented as a separate condition
• •When polycythemia vera leads to complications such as thrombosis, stroke, or myocardial infarction, code those conditions separately in addition to D45

Clinical Significance

Polycythemia vera is a chronic myeloproliferative neoplasm characterized by the JAK2 V617F mutation in over 95% of cases, resulting in uncontrolled red blood cell production. This condition significantly increases the risk of thrombotic events (stroke, pulmonary embolism, deep vein thrombosis) and can transform to myelofibrosis or acute myeloid leukemia over time.

Documentation Requirements

• ✓Documentation should include the polycythemia vera diagnosis with supporting laboratory data: elevated hemoglobin/hematocrit, JAK2 mutation status, erythropoietin levels, and bone marrow biopsy findings.
• ✓Current treatment (phlebotomy, hydroxyurea, aspirin) should be documented.
• ✓Note any thrombotic or hemorrhagic complications and transformation risk factors.

Commonly Confused Codes