Current RMA Instruments
| Reasonable Hypothesis SOP | 63 of 2017 as amended |
| Balance of Probabilities SOP | 64 of 2017 as amended |
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.