What is ICD-10 code D47.3?

D47.3 is the ICD-10-CM diagnosis code for Essential (hemorrhagic) thrombocythemia. Essential thrombocythemia is a blood disorder where the bone marrow produces too many platelets, which can lead to abnormal bleeding or clotting. This is a chronic condition that requires ongoing monitoring and management. D47.3 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. D47.3 is part of the FY2026 ICD-10-CM code set published by the CMS National Center for Health Statistics and used on Medicare, Medicaid, and commercial claims in the United States.

Yes. D47.3 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. D47.3 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

Which HCC does D47.3 map to under V28?

D47.3 maps to CMS-HCC V28 HCC 23 (Prostate, Breast, and Other Cancers and Tumors). The category numbers, labels, and conditions come from the CMS-HCC V28 model file for payment year 2026.

What documentation supports D47.3?

Verify documentation specifies 'essential' or 'primary' thrombocythemia to distinguish from secondary causes of high platelet counts Look for associated complications (thrombosis, hemorrhage) that may require additional codes, and confirm whether the patient is on antiplatelet or anticoagulant therapy Because D47.3 maps to an HCC category, the documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) before the diagnosis is used for risk adjustment. See the MEAT criteria checklist at /meat-criteria for what Monitor, Evaluate, Assess, or Treat looks like in a note. MEAT is generic documentation evidence, not a payer-specific rule.

2026 ICD-10-CM D47.3: Essential (hemorrhagic)

D47.3 maps to CMS-HCC V28 23. A source-labeled RAF reference is available. Documentation must support MEAT. MEAT criteria · RAF Calculator · free HCC coding tools

ICD-10-CM Code View

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Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.

Code lookupD47.3Effective periodFY2026 Apr Update (Apr 1-Sep 30)

FY 2026 Apr update / Neoplasms (C00-D49) / Neoplasms of uncertain behavior, polycythemia vera and myelodysplastic syndromes (D37-D48)

D47.3

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Essential (hemorrhagic) thrombocythemia

Essential thrombocythemia is a blood disorder where the bone marrow produces too many platelets, which can lead to abnormal bleeding or clotting. This is a chronic condition that requires ongoing monitoring and management.

Buddy Insight

Essential thrombocythemia is a chronic myeloproliferative neoplasm characterized by persistent thrombocytosis (platelet count above 450,000/microL) due to clonal megakaryocyte proliferation.

CMS-HCC V28

Mapped

HCC 23

Prostate, Breast, and Other C...

Code-level coefficient reference

CMS-HCC V24

Historical

Not used for standard CY2026 Medicare Advantage payment. Select a historical period to review V24.

Not used for CY2026 payment

ACA/HHS

Mapped

HCC 075

HHS-HCC 075 adult, RAF varies...

Code-level coefficient reference

ESRD/PACE

Mapped

HCC 48

Coagulation Defects and Other...

Code-level coefficient reference

RXHCC

Mapped

HCC 21

Lymphomas and Other Hematolog...

Code-level coefficient reference

Code Book Path

Official

D47Other neoplasms of uncertain behavior of lymphoid, hematopoietic and related tissue

D47.3Essential (hemorrhagic) thrombocythemia

Inclusion Terms

Official

Essential thrombocytosis
Idiopathic hemorrhagic thrombocythemia
Primary thrombocytosis

Excludes 2

Official

reactive thrombocytosis (D75.838)
secondary thrombocytosis (D75.838)
thrombocythemia NOS (D75.839)
thrombocytosis NOS (D75.839)

Related Child Codes

Official

D47.0Mast cell neoplasms of uncertain behavior

D47.1Chronic myeloproliferative disease

D47.2Monoclonal gammopathy

D47.4Osteomyelofibrosis

D47.9Neoplasm of uncertain behavior of lymphoid, hematopoietic and related tissue, unspecified

Includes

Official

ICD-10-CM does not list Includes notes for D47.3 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for D47.3 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for D47.3 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for D47.3 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for D47.3 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

Documentation should include persistently elevated platelet counts, bone marrow biopsy showing megakaryocyte hyperplasia, and molecular testing (JAK2, CALR, or MPL mutations).

World Health Organization diagnostic criteria should be met.

Document cardiovascular risk factors, prior thrombotic events, and current therapy (aspirin, hydroxyurea, anagrelide).

Rule out reactive thrombocytosis.

MEAT Support

HCC Buddy guidance

Documentation should include persistently elevated platelet counts, bone marrow biopsy showing megakaryocyte hyperplasia, and molecular testing (JAK2, CALR, or MPL mutations).

World Health Organization diagnostic criteria should be met.

Document cardiovascular risk factors, prior thrombotic events, and current therapy (aspirin, hydroxyurea, anagrelide).

Rule out reactive thrombocytosis.

Audit Caution

HCC Buddy guidance

Do not assign this code for reactive thrombocytosis, which is far more common and caused by iron deficiency, infection, inflammation, or malignancy.

Essential thrombocythemia requires exclusion of other myeloproliferative neoplasms and reactive causes.

Mutation testing is critical for diagnosis confirmation and should be documented.

Common Mistakes

HCC Buddy guidance

D75.838 (thrombocytosis, unspecified) and D75.839 (reactive thrombocytosis) are used for non-clonal elevated platelets.

D45 (polycythemia vera) may present with thrombocytosis but has predominant erythrocytosis.

D47.1 (chronic myeloproliferative disease) is a broader category.

D47.4 (osteomyelofibrosis) involves bone marrow fibrosis.

Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →

Is D47.3 an HCC code?

Yes. D47.3 (Essential (hemorrhagic) thrombocythemia) maps to HCC 23, Prostate, Breast, and Other Cancers and Tumors under the CMS-HCC V28 risk adjustment model, with a source-labeled community non-dual aged reference coefficient of 0.186. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes. It is billable for payment year 2026.

Coder answer: D47.3 is billable and maps to V28 HCC 23, Prostate, Breast, and Other Cancers and Tumors. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.

Code: D47.3
Description: Essential (hemorrhagic) thrombocythemia
HCC (V28): HCC 23 — Prostate, Breast, and Other Cancers and Tumors
RAF reference coefficient: 0.186
Billable: Yes
Payment year: 2026

HCC Category Mapping

V28HCC 23, Prostate, Breast, and Other Cancers and Tumors

0.186

ESRDHCC 48, Coagulation Defects and Other Specified Hematological Disorders

Not separately weighted

RxHCCHCC 21, Lymphomas and Other Hematologic Cancers

Not separately weighted

These are source-labeled model coefficients, not member totals. A category may still be removed by hierarchy or model cleanup rules. Weights are not directly comparable across models: CMS-HCC V28 and V24 use Community, Non-Dual, Aged; ESRD uses the dialysis continuing-enrollee model; RxHCC is the Part D continuing-enrollee, non-low-income, aged weight (a larger scale than CMS-HCC). ACA/HHS has no single weight — it varies by metal level. Actual per-patient RAF contribution depends on member context, hierarchy and cleanup rules, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains available for historical review.

Work D47.3 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT Criteria for D47.3

For D47.3 to count as a valid HCC diagnosis in a given encounter, the provider's documentation must show MEAT: Monitor, Evaluate, Assess, or Treat. A diagnosis from a prior year does not carry forward automatically, it has to be re-documented and supported each calendar year.

MMonitor: signs, symptoms, disease progression, or lab trending documented in the note
EEvaluate: test results, medication response, or physical findings reviewed by the provider
AAssess: explicit mention in the assessment or plan with acknowledgment of status
TTreat: medication, referral, procedure, therapy, or counseling tied to the diagnosis

Only one of M/E/A/T is required to support the code, but the documentation must be specific enough to show that the provider actually addressed D47.3 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

D47.3 is the ICD-10-CM diagnosis code for essential (hemorrhagic) thrombocythemia. Essential thrombocythemia is a blood disorder where the bone marrow produces too many platelets, which can lead to abnormal bleeding or clotting. This is a chronic condition that requires ongoing monitoring and management. D47.3 sits in the ICD-10-CM chapter for neoplasms (c00-d49), within the section covering neoplasms of uncertain behavior, polycythemia vera and myelodysplastic syndromes (d37-d48).

Under the CMS-HCC V28 risk adjustment model, D47.3 maps to Prostate, Breast, and Other Cancers and Tumors (HCC 23) with a source-labeled community, non-dual, aged reference coefficient of 0.186. No V24 mapping is shown for D47.3; use the applicable model and payment year when reviewing the V28 mapping. V28 is the CMS-HCC risk adjustment model that reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes.

Verify documentation specifies 'essential' or 'primary' thrombocythemia to distinguish from secondary causes of high platelet counts. Because D47.3 maps to an HCC category, the provider's documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) before the diagnosis is used for risk adjustment. When documentation is ambiguous, coders should issue a provider query rather than assume the highest-specificity variant.

HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for D47.3 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Verify documentation specifies 'essential' or 'primary' thrombocythemia to distinguish from secondary causes of high platelet counts
•Look for associated complications (thrombosis, hemorrhage) that may require additional codes, and confirm whether the patient is on antiplatelet or anticoagulant therapy

Clinical Significance

Essential thrombocythemia is a chronic myeloproliferative neoplasm characterized by persistent thrombocytosis (platelet count above 450,000/microL) due to clonal megakaryocyte proliferation. Despite being considered the most indolent of the myeloproliferative neoplasms, it carries risks of both thrombotic events (stroke, deep vein thrombosis) and paradoxical hemorrhagic complications from acquired von Willebrand disease.

Documentation Requirements

✓Documentation should include persistently elevated platelet counts, bone marrow biopsy showing megakaryocyte hyperplasia, and molecular testing (JAK2, CALR, or MPL mutations).
✓World Health Organization diagnostic criteria should be met.
✓Document cardiovascular risk factors, prior thrombotic events, and current therapy (aspirin, hydroxyurea, anagrelide).
✓Rule out reactive thrombocytosis.

Excludes 2, Not included here, may code separately

reactive thrombocytosis (D75.838)
secondary thrombocytosis (D75.838)
thrombocythemia NOS (D75.839)
thrombocytosis NOS (D75.839)

Commonly Confused Codes

•D75.838 (thrombocytosis, unspecified) and D75.839 (reactive thrombocytosis) are used for non-clonal elevated platelets.
•D45 (polycythemia vera) may present with thrombocytosis but has predominant erythrocytosis.
•D47.1 (chronic myeloproliferative disease) is a broader category.
•D47.4 (osteomyelofibrosis) involves bone marrow fibrosis.