Immune Thrombocytopaenia D008

Current RMA Instruments

Changes from previous instruments

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.