D68.51 Activated protein C resistance

ICD10CM code

#### Name of the Condition
- Activated Protein C Resistance (APC Resistance)

#### Summary
Activated Protein C Resistance is a blood clotting disorder where the natural anticoagulant, activated protein C, is less effective at breaking down clotting factors, leading to an increased risk of thrombosis.

#### Causes
The most common cause of APC Resistance is a genetic mutation in the factor V gene, known as Factor V Leiden mutation. This mutation alters the structure of Factor V, making it resistant to inactivation by activated protein C.

#### Risk Factors
- Family history of thrombosis
- Inheritance of the Factor V Leiden mutation
- Being of Caucasian descent 
- Hormonal factors such as pregnancy or use of oral contraceptive pills
- Certain surgeries or immobility

#### Symptoms
- Swelling, pain, or redness in the limbs
- Unexplained pain or swelling in the body
- Increased risk of deep vein thrombosis (DVT) or pulmonary embolism (PE)

#### Diagnosis
- Blood tests to detect Factor V Leiden mutation
- Activated Protein C resistance testing
- Coagulation screening tests

#### Treatment Options
- Anticoagulant medications such as warfarin or direct oral anticoagulants (DOACs) to reduce clot formation.
- Lifestyle adjustments to mitigate risk factors.
- Regular monitoring through blood tests to ensure anticoagulant therapy is effective.

#### Prognosis and Follow-Up
With appropriate treatment, individuals can manage the condition and reduce the risk of thrombosis. Regular follow-up with a healthcare provider is crucial to monitor therapy effectiveness and adjust as needed.

#### Complications
- Increased risk of developing blood clots, including DVT and PE.
- Potential complications from long-term anticoagulation therapy, such as bleeding.
- Rarely, complications during pregnancy, affecting both the mother and the fetus.

#### Lifestyle & Prevention
- Maintain a healthy weight
- Engage in regular physical activity
- Avoid long periods of immobility
- Discuss risks of hormone-based medications with a healthcare provider

#### When to Seek Professional Help
- Sudden onset of limb pain or swelling
- Difficulty breathing or chest pain, which could indicate a pulmonary embolism

#### Additional Resources
- National Blood Clot Alliance (www.stoptheclot.org)
- Genetic and Rare Diseases Information Center (rarediseases.info.nih.gov)
- Thrombosis UK (www.thrombosisuk.org)

#### Tips for Medical Coders
- Ensure coding accuracy by confirming the presence of Factor V Leiden mutation and signs of thrombosis.
- Be aware of related codes for complications such as DVT or PE to ensure appropriate documentation and coding.
- Avoid generalizing coding with other coagulation defects without a confirmed diagnosis of APC resistance.

Medical Policies and Guidelines for Activated protein C resistance

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