Is D68.1 a billable ICD-10-CM code?

Yes. D68.1 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does D68.1 sit in the tabular list?

Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism (D50-D89), in the block Coagulation defects, purpura and other hemorrhagic conditions (D65-D69).

What cannot be coded together with D68.1?

D68.1 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above D68.1 (D68) and apply to it just the same.

D68.1

D68.1 — Hereditary factor XI deficiency

Billable / specific codeICD-10-CM

D68.1 is a billable, specific ICD-10-CM code for hereditary factor xi deficiency. It is valid for submission on a claim.

Inclusion terms

Alternative wordings a physician may use in the chart for this same code.

Hemophilia C
Plasma thromboplastin antecedent [PTA] deficiency
Rosenthal's disease

Excludes1 inherited from the categories above D68.1

These are not written on D68.1, but they bind it: a note on a category applies to every code beneath it. Billing D68.1 with anything listed here is a denial.

Written on D68 — Other coagulation defects

abnormal coagulation profile NOS (R79.1)

Excludes2 inherited from the categories above D68.1

Also inherited, and the opposite of Excludes1: these conditions are not part of D68.1, but a patient can have both, so you may code both.

Written on D68 — Other coagulation defects

coagulation defects complicating abortion or ectopic or molar pregnancy (O00-O07, O08.1)
coagulation defects complicating pregnancy, childbirth and the puerperium (O45.0, O46.0, O67.0, O72.3)

Other codes that can never be billed with D68.1

These codes carry an Excludes1 note pointing at D68.1. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading D68.1 alone.

R79.1Abnormal coagulation profile

Risk adjustment

D68.1 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:

HCC 112 Immune Thrombocytopenia and Specified Coagulation Defects and Hemorrhagic Conditions0.450 RAF

Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score.

Medicare coverage

D68.1 is named in 1 Medicare coverage policy — 1 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A57954Billing and Coding: Routine Foot Care

How D68.1 is indexed

Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to D68.1.

Rosenthal's disease or syndrome
Deficiency, deficient›PTA(plasma thromboplastin antecedent)
Disease, diseased›Rosenthal's(factor XI deficiency)
Hemophilia›C
Deficiency, deficient›factor›XI(congenital) (hereditary)
Deficiency, deficient›plasma thromboplastin›antecedent(PTA)
Deficiency, deficient›anti-hemophilic›factor›C

Code history

D68.1 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Related codes at this level

Codes that share D68. If D68.1 is not quite right, the correct code is usually one of these.

Questions about D68.1

Is D68.1 a billable ICD-10-CM code?: Yes. D68.1 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does D68.1 sit in the tabular list?: Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism (D50-D89), in the block Coagulation defects, purpura and other hemorrhagic conditions (D65-D69).
What cannot be coded together with D68.1?: D68.1 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above D68.1 (D68) and apply to it just the same.