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Immune Thrombocytopaenia D008

Document
Last amended 
31 October 2017
Current RMA Instruments
Reasonable Hypothesis SOP 63 of 2017
Balance of Probabilities SOP  64 of 2017
Changes from previous instruments

SOP Bulletin 199

ICD Coding
  • ICD-9-CM Codes: 287.3, 287.4
  • ICD-10-AM Codes: D69.6
Brief description

Immune thrombocytopaenia is an autoimmune disorder resulting in destruction of platelets and a low platelet count.  It can be a stand alone condition or occur in conjunction with another disorder.

Confirming the diagnosis

This diagnosis is complex.  Clinical manifestations (bleeding) or a need for treatment are required.  Non-immunological causes and haematological disorders also involving other blood components need to be excluded. The condition can be temporary and may no longer be present.

The relevant medical specialist is a haematologist.

Additional diagnoses covered by SOP
  • Idiopathic thrombocytopaenic purpura
  • Immune thrombocytopaenic purpura
  • Secondary thrombocytopaenic purpura due to immune mechanisms
Conditions that may be covered by SOP
  • Drug-induced thrombocytopaenia (can be immune based, due to marrow suppression or due to platelet aggregation)
Conditions not covered by SOP
  • Allergic thrombocytopaenia# (ICD-9 287.5; ICD-10 D69.4)
  • Essential (haemorrhagic) thrombocythaemia*
  • Evan’s syndrome# (ICD-9 287.5; ICD-10 D69.4)
  • Non-immunological thrombocytopaenia# (ICD-9 287.5; ICD-10 D69.4)
  • Pancytopaenia# (ICD-9 284.0-9; ICD-10 D61.3-9)
  • Pseudothrombocytopaenia – laboratory artefact, not a disease
  • Qualitative platelet defects (ICD-9 287.1; ICD-10 D69.1)
  • Thrombocytopaenia in the presence of abnormal red or white cells, code to underlying condition
  • Thrombotic thrombocytopaenic purpura# (ICD-9 446.6; ICD-10 M31.1)

* another SOP applies

# non-SOP condition

Clinical onset

Clinical onset may be when bleeding manifestations were first noticed or may be when a low platelet count was first noted on testing.

Clinical worsening

This may be evidenced by a fall in the platelet count or more severe bleeding manifestations.