D68.61: Antiphospholipid syndrome
D68.61 is a billable, specific ICD-10-CM code for antiphospholipid syndrome. It is valid for submission on a claim.
Check D68.61 with the rest of the claim: free scrubberExcludes1: never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
- anti-phospholipid antibody, finding without diagnosis (R76.0)
Excludes2: not included here, but may coexist
The excluded condition is not part of this code, but a patient can have both. You may code both.
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Anticardiolipin syndrome
- Antiphospholipid antibody syndrome
Excludes1 inherited from the categories above D68.61
A category’s note binds every code beneath it.
Written on D68.6: Other thrombophilia
Excludes2 inherited from the categories above D68.61
Not part of this code, but both may be coded when both are present.
Other codes that can never be billed with D68.61
Their own Excludes1 notes name this code, so the conflict is not listed above.
Risk adjustment
No CMS-HCC V28 category: this code does not change a RAF score.
Medicare coverage
D68.61 is named in 2 Medicare coverage policies: 2 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A56464Billing and Coding: Flow Cytometry
- A57594Billing and Coding: Non-Invasive Peripheral Venous Vascular and Hemodialysis Access Studies
Alphabetic index entries that lead here
- Anticardiolipin syndrome
- Syndrome›anticardiolipin(-antibody)
- Syndrome›antiphospholipid(-antibody)
- Antiphospholipid›antibody›syndrome
- Antibody›anticardiolipin›with›hypercoagulable state
- Antibody›antiphosphatidylglycerol›with›hypercoagulable state
- Antibody›antiphosphatidylinositol›with›hypercoagulable state
- Antibody›antiphosphatidylserine›with›hypercoagulable state
- Antibody›antiphospholipid›with›hypercoagulable state
Code history
Unchanged in every release from FY2024 to FY2027.