Lymphocytic Variant Hypereosinophilic Syndrome [LHES]

This code identifies a rare, chronic myeloproliferative disorder characterized by persistent, unexplained eosinophilia exceeding 1,500 cells/µL for at least six months, along with signs of organ damage attributable to eosinophil infiltration. Specifically, it denotes the lymphocytic variant, where an underlying clonal T-cell population drives the eosinophilia. This variant often presents with skin lesions, lymphadenopathy, and elevated IgE levels.

Apply this code when documentation clearly indicates a diagnosis of Lymphocytic Variant Hypereosinophilic Syndrome (LHES). This diagnosis is typically supported by persistent eosinophilia, evidence of eosinophil-mediated organ damage, and identification of an aberrant T-cell clone (e.g., via flow cytometry or T-cell receptor gene rearrangement studies). Use this code when the specific LHES subtype has been confirmed by a hematologist or immunologist.

• Ensure documentation specifies "lymphocytic variant" to differentiate from other forms of hypereosinophilic syndrome.
• Do not confuse with unspecified hypereosinophilic syndrome (D72.19) or other eosinophilic disorders without the specific LHES criteria.
• Code any associated organ manifestations (e.g., cardiomyopathy, neuropathy) separately as secondary diagnoses.