D45
D45: Polycythemia vera
Billable / specific codeICD-10-CM
D45 is a billable, specific ICD-10-CM code for polycythemia vera. It is valid for submission on a claim.
Check D45 with the rest of the claim: free scrubberOther codes that can never be billed with D45
Their own Excludes1 notes name this code, so the conflict is not listed above.
Risk adjustment
D45 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 23 Prostate, Breast, and Other Cancers and Tumors0.186 RAF
Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score. Look up the whole chart to see which of its HCCs the hierarchy would zero.
Medicare coverage
D45 is named in 43 Medicare coverage policies: 41 listing it as supporting medical necessity, and 2 listing it as NOT covered. Which one applies depends on your Medicare contractor.
- A56462Billing and Coding: Erythropoiesis Stimulating Agents (ESA)not covered
- A60435Billing and Coding: Erythropoiesis Stimulating Agents (ESA)not covered
- A52480Oral Antiemetic Drugs (Replacement for Intravenous Antiemetics) - Policy Article
- A52986Billing and Coding: Biomarkers for Oncology
Alphabetic index entries that lead here
- Heilmeyer-Schoner disease
- Erythremia›chronic
- Polycythemia›vera
Code history
Unchanged in every release from FY2024 to FY2027.