2026 ICD-10-CM Diagnosis Code D45Polycythemia vera
ICD-10-CM Codes›C00–D49›D37-D48›D45
- Billable — Valid for Submission
- Risk Adjusts — HCC 23
- Chronic Condition
D45 is a billable ICD-10-CM diagnosis code for polycythemia vera. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 820 through 825, 840 through 842. Coders also document this condition as chorea due to polycythemia rubra vera. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Neoplasms of unspecified nature or uncertain behavior.
For Medicare Advantage risk adjustment, D45 maps to CMS-HCC Category 23 (Prostate, Breast, and Other Cancers and Tumors) under the V28 model, adding a risk factor of about 0.186 for a community, non-dual, aged beneficiary in payment year 2026.
Code Identity
Code Classification
Medicare Risk Adjustment (HCC)Billing
D45 maps to a payment category in the CMS-HCC model used to risk-adjust Medicare Advantage payments. Weights are the published community factors for payment year 2026.
Source: CMS Payment Year 2026 risk adjustment mappings and model software. Weights are relative factors, not dollar amounts; a beneficiary's total RAF also includes demographics and interactions. Browse all CMS-HCC categories.
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Chorea due to polycythemia rubra vera
- Erythrocytosis due to polycythemia vera
- Myelofibrosis
- Myelofibrosis due to another disorder
- Polycythemia vera
- Polycythemia vera in remission
- Post-polycythemia vera myelofibrosis
Tabular List NotesGuidance
Coding notes and annotation back-references applicable to this code.
Type 1 Excludes
A type 1 excludes note is a pure excludes note. It means "NOT CODED HERE!" An Excludes1 note indicates that the code excluded should never be used at the same time as the code above the Excludes1 note. An Excludes1 is used when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition.
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Clinical InformationClinical
Polycythemia Vera
a myeloproliferative disorder of unknown etiology, characterized by abnormal proliferation of all hematopoietic bone marrow elements and an absolute increase in red cell mass and total blood volume, associated frequently with splenomegaly, leukocytosis, and thrombocythemia. hematopoiesis is also reactive in extramedullary sites (liver and spleen). in time myelofibrosis occurs.
Patient EducationClinical
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 the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert D45 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About D45Overview
What is the ICD-10 code for polycythemia vera?
The ICD-10-CM code for polycythemia vera is D45. It is billable on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
Is D45 (Polycythemia vera) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report polycythemia vera on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
What MS-DRG does D45 group to?
When polycythemia vera is the principal diagnosis on an inpatient stay, it groups to MS-DRG 820, 821, 822, 823, 824, 825, 840, 841, 842, with relative weights from 1.0104 to 5.8648 depending on complications. Higher weights mean higher Medicare reimbursement.
What is the ICD-9 equivalent of D45?
Under the General Equivalence Mappings, polycythemia vera converts to ICD-9-CM 207.10 (chr erythrm w/o ach rmsn), 207.11 (chr erythrm w remision), and 207.12 (chr erythrmia in relapse). The mapping is approximate, so confirm the match fits the documentation.
What HCC is D45?
D45 (polycythemia vera) maps to CMS-HCC Category 23 (Prostate, Breast, and Other Cancers and Tumors), commonly written as HCC 23, in the CMS-HCC V28 model used for Medicare Advantage risk adjustment in payment year 2026. It mapped to HCC 48 under the retired V24 model. It also maps in the PACE (CMS-HCC V22), ESRD (V21), and ESRD (V24) models. In the Part D prescription drug model it maps to RxHCC 21.
Does D45 risk-adjust for Medicare Advantage payment?
Yes. When documented and reported on a Medicare Advantage encounter, D45 adds a risk adjustment factor of about 0.186 to the beneficiary's RAF score for a community, non-dual, aged enrollee (published V28 weights range from 0.186 to 0.237 depending on the payment segment). A more severe related category (HCC 17, HCC 18, HCC 19, HCC 20, HCC 21, and HCC 22) supersedes it when both are reported. See the full factor table on the HCC 23 category page.
