D68.59 — Other primary thrombophilia
D68.59 is a billable, specific ICD-10-CM code for other primary thrombophilia. It is valid for submission on a claim.
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Antithrombin III deficiency
- Hypercoagulable state NOS
- Primary hypercoagulable state NEC
- Primary thrombophilia NEC
- Protein C deficiency
- Protein S deficiency
- Thrombophilia NOS
Excludes1 inherited from the categories above D68.59
These are not written on D68.59, but they bind it: a note on a category applies to every code beneath it. Billing D68.59 with anything listed here is a denial.
Written on D68.5 — Primary thrombophilia
- antiphospholipid syndrome (D68.61)
- lupus anticoagulant (D68.62)
- secondary activated protein C resistance (D68.69)
- secondary antiphospholipid antibody syndrome (D68.69)
- secondary lupus anticoagulant with hypercoagulable state (D68.69)
- secondary systemic lupus erythematosus [SLE] inhibitor with hypercoagulable state (D68.69)
- systemic lupus erythematosus [SLE] inhibitor finding without diagnosis (R76.0)
- systemic lupus erythematosus [SLE] inhibitor with hemorrhagic disorder (D68.312)
- thrombotic thrombocytopenic purpura (M31.19)
Excludes2 inherited from the categories above D68.59
Also inherited, and the opposite of Excludes1: these conditions are not part of D68.59, but a patient can have both, so you may code both.
Other codes that can never be billed with D68.59
These codes carry an Excludes1 note pointing at D68.59. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading D68.59 alone.
- R79.1Abnormal coagulation profile
Risk adjustment
D68.59 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.
Medicare coverage
D68.59 is named in 2 Medicare coverage policies — 2 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A56065Billing and Coding: Guidance for Anti-Inhibitor Coagulant Complex (AICC) National Coverage Determination (NCD) 110.3
- A57594Billing and Coding: Non-Invasive Peripheral Venous Vascular and Hemodialysis Access Studies
How D68.59 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 D68.59.
- Hypercoagulable(state)
- Hypercoagulation(state)
- Thrombophilia
- Deficiency, deficient›antithrombin(antithrombin III)
- Hypercoagulable›antithrombin deficiency(III)
- Hypercoagulable›primary NEC
- Hypercoagulable›protein C deficiency
- Hypercoagulable›protein S deficiency
- Thrombophilia›primary NEC
- Deficiency, deficient›protein›C
- Deficiency, deficient›protein›S
Code history
D68.59 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 D68.5. If D68.59 is not quite right, the correct code is usually one of these.
Questions about D68.59
- Is D68.59 a billable ICD-10-CM code?
- Yes. D68.59 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does D68.59 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 D68.59?
- D68.59 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 D68.59 (D68.5, D68) and apply to it just the same.