ICD-10 D45
Billable / Specific HCC v28: 48Polycythemia vera
About ICD-10-CM D45
ICD-10-CM code D45 represents Polycythemia vera. This is a billable/specific code in the Neoplasms chapter (block D45). The 2026 edition of ICD-10-CM D45 became effective on October 1, 2025.
Coding Tips for D45
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
D45 is a CMS-HCC v28 risk-adjustment code (category 48). To count for the patient Risk Adjustment Factor (RAF), document the diagnosis with MEAT language each calendar year: Monitored, Evaluated, Assessed, Treated. A diagnosis on the problem list alone does not satisfy CMS RADV audit standards. Include the diagnosis in the assessment with current status and current treatment plan.
Type 1 Excludes
Pure excludes, these codes can never be coded together with D45. The conditions are mutually exclusive (e.g., congenital vs acquired forms).
- familial polycythemia (D75.0)
- secondary polycythemia (D75.1)
Medicare Advantage HCC Impact
Capture this diagnosis annually for accurate risk adjustment. Missed HCC captures are the #1 revenue leak in Medicare Advantage risk programs.
Medicare LCD Coverage for D45
Local Coverage Determinations (LCDs) from CMS MACs that list D45 as a covered diagnosis.
Showing top 10 of 1,314 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing D45.
1 Aetna
1 Cigna
5 Medicare
CPT Codes Commonly Billed with D45
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
- 81450 CMS LCD: Billing and Coding: MolDX: Next-Generation Sequencing Lab-Developed Tests for Myeloid Malignancies and Suspected Myeloid Malignancies CMS LCD
- 81451 CMS LCD: Billing and Coding: MolDX: Next-Generation Sequencing Lab-Developed Tests for Myeloid Malignancies and Suspected Myeloid Malignancies CMS LCD
- 0027U CMS LCD: Billing and Coding: MolDX: Non-Next Generation Sequencing Tests for the Diagnosis of BCR-ABL Negative Myeloproliferative Neoplasms CMS LCD
- 81270 CMS LCD: Billing and Coding: MolDX: Non-Next Generation Sequencing Tests for the Diagnosis of BCR-ABL Negative Myeloproliferative Neoplasms CMS LCD
- 81338 CMS LCD: Billing and Coding: MolDX: Non-Next Generation Sequencing Tests for the Diagnosis of BCR-ABL Negative Myeloproliferative Neoplasms CMS LCD
- 81339 CMS LCD: Billing and Coding: MolDX: Non-Next Generation Sequencing Tests for the Diagnosis of BCR-ABL Negative Myeloproliferative Neoplasms CMS LCD
- 81219 CMS LCD: Billing and Coding: MolDX: Non-Next Generation Sequencing Tests for the Diagnosis of BCR-ABL Negative Myeloproliferative Neoplasms CMS LCD
- 81279 CMS LCD: Billing and Coding: MolDX: Non-Next Generation Sequencing Tests for the Diagnosis of BCR-ABL Negative Myeloproliferative Neoplasms CMS LCD
Convert D45 to ICD-9-CM
Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.
| ICD-10 | ICD-9 | Mapping Flags |
|---|---|---|
| D45 | 20710 | 10000 |
| D45 | 20711 | 10000 |
| D45 | 20712 | 10000 |
| D45 | 2384 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To D45
Other codes in section D37-D48 (Neoplasms of uncertain behavior, polycythemia vera and myelodysplastic syndromes).
ICD-10 D45, Billing FAQ
Is ICD-10 code D45 billable? +
Yes, D45 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
What codes are Type 1 Excludes for D45? +
Type 1 Excludes (never code together with D45): familial polycythemia (D75.0); secondary polycythemia (D75.1)
Does D45 affect Medicare Advantage HCC risk adjustment? +
Yes. D45 maps to CMS-HCC v28 category 48. Capture this diagnosis annually for accurate Medicare Advantage risk score.
What CPT codes are commonly billed with D45? +
Procedures frequently paired with D45 include: 81450, 81451, 0027U, 81270, 81338.
What ICD-9 codes does D45 map to? +
Per CMS GEMs, D45 maps to ICD-9 codes: 20710, 20711, 20712, 2384. Useful for legacy data review and historical claim analysis.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on July 16, 2026.
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