D70.4

HCC Category Mapping

What This Code Means

A rare condition where white blood cell counts regularly rise and fall in a predictable cycle.

Coding Tips

• •This is a chronic condition with periodic fluctuations; document the cyclical pattern in the record
• •Distinguish from other causes of neutropenia by confirming the regular, recurring nature of the condition

Clinical Significance

Cyclic neutropenia is a rare inherited disorder characterized by regular oscillations in neutrophil counts, typically with a 21-day cycle, during which neutrophil counts drop to near zero for 3-5 days. During neutropenic nadirs, patients are susceptible to mouth ulcers, periodontal disease, and potentially life-threatening infections. Most cases are caused by ELANE gene mutations.

Documentation Requirements

• ✓Document serial absolute neutrophil counts demonstrating the cyclic pattern (minimum three cycles), ELANE gene mutation testing results, typical cycle length, severity of nadir counts, and associated symptoms during neutropenic episodes.
• ✓Record G-CSF use, dental health status, and infection prevention strategies.

Commonly Confused Codes