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.

What is the V28 vs V24 difference for D47.3?

CMS phased in the V28 risk adjustment model over payment years 2024 (33%), 2025 (67%), and 2026 (100%), replacing V24. V28 consolidates HCC categories, removes some lower-acuity conditions, and recalibrates RAF weights across the entire model. For D47.3, V28 maps to Melanoma and Other Skin Cancers at RAF 0.251 while V24 mapped to Coagulation Defects and Other Specified Hematological Disorders at RAF 0.209. Both models can still appear in legacy data and in payer-specific lookback periods.

What should coders know when reporting 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 a payment HCC, the documentation must also satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's risk adjustment score.

D47.3 ICD-10 Code: Essential (hemorrhagic)

ICD-10-CM Code View

HCC Buddy Code Card

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

Melanoma and Other Skin Cancers

RAF 0.251

CMS-HCC V24

Mapped

HCC 48

Coagulation Defects and Other...

RAF 0.209

ACA/HHS

Not risk-adjusted for this model/period.

RAF 0

ESRD/PACE

Mapped

HCC 48

Coagulation Defects and Other...

RAF 0.0

RXHCC

Mapped

HCC 21

Hodgkin Lymphoma and Other Ca...

RAF 0.0

Code Trumping

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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.

Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.

Is D47.3 an HCC code?

Yes. D47.3 maps to Melanoma and Other Skin Cancers under the CMS-HCC V28 risk adjustment model (and Coagulation Defects and Other Specified Hematological Disorders under V24).

HCC Category Mapping

V28HCC 23, Melanoma and Other Skin Cancers

0.251

V24HCC 48, Coagulation Defects and Other Specified Hematological Disorders

0.209

ESRDHCC 48, Coagulation Defects and Other Specified Hematological Disorders

0.000

RxHCCHCC 21, Hodgkin Lymphoma and Other Cancers

0.000

RAF weights shown are the community, non-dual, aged base weights from the CMS risk adjustment model file. Actual per-patient RAF contribution depends on member segment, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains in use during the transition and for historical data.

MEAT Criteria for D47.3

For D47.3to 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.

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 Melanoma and Other Skin Cancers (HCC 23) with a community, non-dual, aged base RAF weight of 0.251. Under the older CMS-HCC V24 model, D47.3 maps to Coagulation Defects and Other Specified Hematological Disorders (HCC 48) with a community, non-dual, aged base RAF weight of 0.209. 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.

Verify documentation specifies 'essential' or 'primary' thrombocythemia to distinguish from secondary causes of high platelet counts. Because D47.3 maps to a payment HCC, the provider's documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's Medicare Advantage risk adjustment score. 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, RAF weights, 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.