Polycythemia vera
Chapter 2:Neoplasms
ICD-10 D45 is a billable code used to indicate a diagnosis of polycythemia vera.
Polycythemia vera (PV) is a myeloproliferative neoplasm characterized by the overproduction of red blood cells, often accompanied by increased white blood cells and platelets. This condition arises from a mutation in the JAK2 gene, leading to uncontrolled hematopoiesis. Patients may present with symptoms such as headaches, dizziness, pruritus, and a ruddy complexion due to increased blood viscosity. PV is classified as a neoplasm of uncertain behavior, as it has the potential to progress to more severe forms of myeloproliferative disorders or acute myeloid leukemia (AML). Diagnosis is typically confirmed through blood tests showing elevated hemoglobin and hematocrit levels, alongside bone marrow biopsy findings. Surveillance is crucial for managing PV, as it requires regular monitoring for complications such as thrombosis, hemorrhage, and transformation to more aggressive malignancies. Treatment options include phlebotomy, low-dose aspirin, and cytoreductive therapy, depending on the patient's risk factors and clinical presentation.
Detailed blood work results, bone marrow biopsy findings, and treatment plans.
Diagnosis confirmation, management of complications, and routine follow-up visits.
Ensure documentation reflects the chronic nature of the disease and any changes in treatment.
Oncological assessments, treatment response evaluations, and any transformation to acute leukemia.
Management of PV with potential transformation to more aggressive malignancies.
Document any signs of progression or transformation to ensure accurate coding.
Used to monitor blood cell levels in patients with PV.
Document the reason for the CBC and any significant findings.
Hematologists should ensure that the CBC is linked to the diagnosis of PV.
The primary treatment for polycythemia vera includes phlebotomy to reduce red blood cell mass, along with low-dose aspirin to decrease thrombotic risk. In some cases, cytoreductive therapy may be indicated.