Polycythemia vera
In Neoplasms of uncertain behavior, polycythemia vera and myelodysplastic syndromes (D37-D48), chapter 2: Neoplasms
- D45 is billable and valid on claims for FY 2027. If the record has more detail, check the other codes under D37-D48 below.
- As a secondary diagnosis it is not a CC or MCC, so it doesn't raise the MS-DRG payment.
- Counts toward HCC 23 (Prostate, Breast, and Other Cancers and Tumors) in the Medicare Advantage risk model (CMS-HCC V28).
- AHRQ's Chronic Condition Indicator classes it as chronic: expected to last 12 months or longer and to limit daily life or need ongoing care.
- 235 US deaths in 2024 had an underlying cause in category D45, per the National Vital Statistics System on CDC WONDER. Death records use WHO ICD-10, so the count is for the whole category.
Also indexed as: Erythremia, chronic; Heilmeyer-Schoner disease; Polycythemia, vera
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Instructional notes
Also applies, from Neoplasms of uncertain behavior, polycythemia vera and myelodysplastic syndromes (D37-D48)
These notes sit on D37-D48 and apply to every code under it, including D45.
Excludes1: not coded here, use a different code
- neoplasms of unspecified behavior (D49.-)
Official coding guidelines
From the ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027 (CMS and NCHS). Links open the PDF at the right page.
Rules for coding benign and malignant neoplasms: using the Neoplasm Table, sequencing primary and secondary sites, treatment encounters, complications, and current cancer versus personal history.
- Admission/Encounter for treatment of primary site (page 33)
- Admission/Encounter for treatment of secondary site (page 33)
- Coding and sequencing of complications (page 34)
- Primary malignancy previously excised (page 34)
- Admissions/Encounters involving antineoplastic chemotherapy, immunotherapy and radiation therapy (page 35)
- Admission/encounter to determine extent of malignancy (page 36)
- Symptoms, signs, and abnormal findings listed in Chapter 18 associated with neoplasms (page 36)
- Admission/encounter for pain control/management (page 36)
Other codes under D37-D48
Neoplasms of uncertain behavior, polycythemia vera and myelodysplastic syndromes (D37-D48)
- D37Neoplasm of uncertain behavior of oral cavity and digestive organs
- D38Neoplasm of uncertain behavior of middle ear and respiratory and intrathoracic organs
- D39Neoplasm of uncertain behavior of female genital organs
- D40Neoplasm of uncertain behavior of male genital organs
- D41Neoplasm of uncertain behavior of urinary organs
- D42Neoplasm of uncertain behavior of meninges
- D43Neoplasm of uncertain behavior of brain and central nervous system
- D44Neoplasm of uncertain behavior of endocrine glands
- D45Polycythemia vera(this code)
- D46Myelodysplastic syndromes
- D47Other neoplasms of uncertain behavior of lymphoid, hematopoietic and related tissue
- D48Neoplasm of uncertain behavior of other and unspecified sites
D45 MS-DRGs
As the principal diagnosis, D45 groups to these 9 MS-DRGs (v44.0). Which one applies depends on procedures performed, secondary diagnoses (CC/MCC), and the patient's age and discharge status.
- DRG 820 Lymphoma and Leukemia with Major O.R. Procedures with MCC
- DRG 821 Lymphoma and Leukemia with Major O.R. Procedures with CC
- DRG 822 Lymphoma and Leukemia with Major O.R. Procedures without CC/MCC
- DRG 823 Lymphoma and Non-Acute Leukemia with Other Procedures with MCC
- DRG 824 Lymphoma and Non-Acute Leukemia with Other Procedures with CC
- DRG 825 Lymphoma and Non-Acute Leukemia with Other Procedures without CC/MCC
- DRG 840 Lymphoma and Non-Acute Leukemia with MCC
- DRG 841 Lymphoma and Non-Acute Leukemia with CC
- DRG 842 Lymphoma and Non-Acute Leukemia without CC/MCC
Related conditions
Grouped by AHRQ's Clinical Classifications Software Refined (CCSR), which sorts every diagnosis code into clinically meaningful categories.
D45 is in Neoplasms of unspecified nature or uncertain behavior (NEO072, its default category), with 118 codes. Others in it:
- D37.01 Neoplasm of uncertain behavior of lip
- D37.02 Neoplasm of uncertain behavior of tongue
- D37.030 Neoplasm of uncertain behavior of the parotid salivary glands
- D37.031 Neoplasm of uncertain behavior of the sublingual salivary glands
- D37.032 Neoplasm of uncertain behavior of the submandibular salivary glands
- D37.039 Neoplasm of uncertain behavior of the major salivary glands, unspecified
- D37.04 Neoplasm of uncertain behavior of the minor salivary glands
- D37.05 Neoplasm of uncertain behavior of pharynx
Medicare coverage articles listing D45
These 17 Medicare billing and coding articles list D45 as a diagnosis that supports medical necessity for the services they cover. From the CMS Medicare Coverage Database; check your own contractor's article before billing.
- MolDX: Minimal Residual Disease Testing for Hematologic Cancers (4 contractors)
- MolDX: Next-Generation Sequencing Lab-Developed Tests for Myeloid Malignancies and Suspected Myeloid Malignancies (4 contractors)
- MolDX: Non-Next Generation Sequencing Tests for the Diagnosis of BCR-ABL Negative Myeloproliferative Neoplasms (4 contractors)
- MolDX: Lab-Developed Tests for Inherited Cancer Syndromes in Patients with Cancer (3 contractors)
- Lab: Flow Cytometry (2 contractors)
- Peripheral Nerve Blocks (2 contractors)
- Biomarkers for Oncology
- CT of the Abdomen and Pelvis
- CT of the Head
- Computerized Axial Tomography (CT), Thorax
And 7 more.
Other codes that refer to D45
Notes on these codes point to D45.
About the condition
Plain-language background from MedlinePlus (National Library of Medicine), not coding guidance.
Bone Marrow Diseases
Bone marrow is the spongy tissue inside some of your bones, such as your hip and thigh bones. It contains stem cells. The stem cells can develop into the red blood cells that carry oxygen through your body, the white blood cells that fight infections, and the platelets that help with blood clotting.
Read more about bone marrow diseases on MedlinePlusCode history
Valid since FY2016, when ICD-10-CM took effect on October 1, 2015. No changes since.
ICD-9-CM equivalent
Legacy crosswalk from the CMS General Equivalence Mappings (last updated 2018).
- 207.10 Chronic erythremia, without mention of having achieved remission (approximate)
- 207.11 Chronic erythremia, in remission (approximate)
- 207.12 Chronic erythremia, in relapse (approximate)
- 238.4 Polycythemia vera (approximate)