D69.42 — Congenital and hereditary thrombocytopenia purpura
D69.42 is a billable, specific ICD-10-CM code for congenital and hereditary thrombocytopenia purpura. It is valid for submission on a claim.
Code first
The underlying condition must be sequenced before this code.
- congential or hereditary disorder, such as:
- thrombocytopenia with absent radius (TAR syndrome) (Q87.2)
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Congenital thrombocytopenia
- Hereditary thrombocytopenia
Risk adjustment
D69.42 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
D69.42 is named in 13 Medicare coverage policies — 13 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A55639Billing and Coding: Chemotherapy Agents for Non-Oncologic Conditions
- A55717Billing and Coding: Lab: Flow Cytometry
- A56380Billing and Coding: Rituximab
- A56416Billing and Coding: Assays for Vitamins and Metabolic Function
How D69.42 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 D69.42.
- Thrombocytopenia, thrombocytopenic›congenital
- Thrombocytopenia, thrombocytopenic›hereditary
- Purpura›thrombocytopenic›congenital
- Purpura›thrombocytopenic›hereditary
Related codes at this level
Codes that share D69.4. If D69.42 is not quite right, the correct code is usually one of these.
Questions about D69.42
- Is D69.42 a billable ICD-10-CM code?
- Yes. D69.42 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does D69.42 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).