D89.1
BillableCryoglobulinemia
HCC Category Mapping
V24HCC 23 — Other Significant Endocrine and Metabolic Disorders
0.230ESRDHCC 23 — Other Significant Endocrine and Metabolic Disorders
0.000RxHCCHCC 99 — Immunodeficiencies
0.000What This Code Means
A condition where abnormal proteins in the blood precipitate in cold temperatures, causing inflammation and damage to blood vessels, nerves, and organs.
Coding Tips
- •Specify the type of cryoglobulinemia (Type I, II, or III) if documented
- •Document associated conditions such as hepatitis C, which is a common cause of Type II cryoglobulinemia
Clinical Significance
Cryoglobulinemia involves the presence of abnormal immunoglobulins that precipitate at temperatures below 37 degrees Celsius, causing vasculitis and end-organ damage. It is classified into three types: Type I (monoclonal, associated with hematologic malignancies), Type II (mixed monoclonal and polyclonal, strongly associated with hepatitis C), and Type III (polyclonal). Clinical manifestations include purpura, arthralgia, peripheral neuropathy, and glomerulonephritis.
Documentation Requirements
- ✓Documentation must confirm the diagnosis of cryoglobulinemia with laboratory testing (positive cryoglobulin levels, cryocrit measurement) and clinical manifestations.
- ✓The type of cryoglobulinemia should be specified if known.
- ✓The underlying etiology (hepatitis C, lymphoproliferative disorder, autoimmune disease) must be documented.
- ✓Treatment details and organ involvement should be recorded.
Commonly Confused Codes
D89.0 (Polyclonal hypergammaglobulinemia) involves elevated immunoglobulins without cold precipitation.D47.2 (Monoclonal gammopathy) may be the underlying cause of Type I cryoglobulinemia but is a separate diagnosis.M31.1 (Thrombotic microangiopathy) can present similarly with vasculitis.B18.2 (Chronic viral hepatitis C) is the most common underlying cause and should be coded additionally when present.