2027 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 2027 (October 1, 2026 through September 30, 2027) 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 2027.
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 2027.
Source: CMS Payment Year 2027 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
- Neoplastic sequelae of disorders
- Polycythemia vera
- Polycythemia vera in remission
- Post-polycythemia vera myelofibrosis
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to D45: its own notes plus those printed at block D37-D48 and Chapter 2. A note printed at a category, block or chapter applies to every code under it.
Excludes1
Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.
- neoplasms of unspecified behavior (D49.-)
Notes
General instructions on how these codes are used.
- Functional activity
- All neoplasms are classified in this chapter, whether they are functionally active or not. An additional code from Chapter 4 may be used, to identify functional activity associated with any neoplasm.
- Morphology [Histology]
- Chapter 2 classifies neoplasms primarily by site (topography), with broad groupings for behavior, malignant, in situ, benign, etc. The Table of Neoplasms should be used to identify the correct topography code. In a few cases, such as for malignant melanoma and certain neuroendocrine tumors, the morphology (histologic type) is included in the category and codes.
- Primary malignant neoplasms overlapping site boundaries
- A primary malignant neoplasm that overlaps two or more contiguous (next to each other) sites should be classified to the subcategory/code .8 ('overlapping lesion'), unless the combination is specifically indexed elsewhere. For multiple neoplasms of the same site that are not contiguous, such as tumors in different quadrants of the same breast, codes for each site should be assigned.
- Malignant neoplasm of ectopic tissue
- Malignant neoplasms of ectopic tissue are to be coded to the site mentioned, e.g., ectopic pancreatic malignant neoplasms are coded to pancreas, unspecified (C25.9).
Source: CMS ICD-10-CM Tabular List. How to read instructional notes.
Referenced in Other NotesGuidance
Instructional notes printed at other codes that name D45, its category, or a range that includes it.
Excludes1 2
These codes carry an Excludes1 note naming D45: they are not reported together with it, unless the two conditions are unrelated.
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, 2026 through September 30, 2027.
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, 2026 through September 30, 2027.
What MS-DRG does D45 group to?
When polycythemia vera is the principal diagnosis on an inpatient stay, it groups to MS-DRG 841, 821, 822, 825, 842, 824, 840, 820, 823, with relative weights from 0.9948 to 6.2454 depending on complications. Higher weights mean higher Medicare reimbursement.
Can D45 be reported with D75.0?
Not as a rule. The Excludes1 note on D45 lists "familial polycythemia (D75.0)". An Excludes1 note means the excluded code is never reported together with this one; the only exception is when the two conditions are unrelated to each other (Official Guidelines, Section I.A.12.a).
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 2027. 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.
