D68.59
D68.59: Other primary thrombophilia
Billable / specific codeICD-10-CM
D68.59 is a billable, specific ICD-10-CM code for other primary thrombophilia. It is valid for submission on a claim.
Check D68.59 with the rest of the claim: free scrubberInclusion 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
A category’s note binds every code beneath it.
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
Not part of this code, but both may be coded when both are present.
Other codes that can never be billed with D68.59
Their own Excludes1 notes name this code, so the conflict is not listed above.
- R79.1Abnormal coagulation profile
Risk adjustment
No CMS-HCC V28 category: this code does not change a RAF score.
Medicare coverage
D68.59 is named in 2 Medicare coverage policies: 2 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- 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
Alphabetic index entries that lead here
- 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
Unchanged in every release from FY2024 to FY2027.