What is ICD-10 code D65?

D65 is the ICD-10-CM diagnosis code for Disseminated intravascular coagulation [defibrination syndrome]. A serious condition where blood clots form throughout the body while simultaneously bleeding occurs due to consumption of clotting factors. D65 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. D65 is part of the FY2026 ICD-10-CM code set published by the CMS National Center for Health Statistics and used on Medicare, Medicaid, and commercial claims in the United States.

Yes. D65 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. D65 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

What is the V28 vs V24 difference for D65?

CMS phased in the V28 risk adjustment model over payment years 2024 (33%), 2025 (67%), and 2026 (100%), replacing V24. V28 consolidates HCC categories, removes some lower-acuity conditions, and recalibrates RAF weights across the entire model. D65 was a payment HCC under V24 (Coagulation Defects and Other Specified Hematological Disorders) but the V28 recalibration removed it from the risk adjustment model. Both models can still appear in legacy data and in payer-specific lookback periods.

What should coders know when reporting D65?

Always identify and code the underlying cause (sepsis, trauma, malignancy, etc.) This is often an acute, life-threatening condition requiring immediate intervention Because D65 maps to a payment HCC, the documentation must also satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's risk adjustment score.

D65: Disseminated intravascular coagulation [defibrination syndrome] — ICD-10 | Coagulation

ICD-10-CM Code View

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Code lookupD65Effective periodFY2026 Apr Update (Apr 1-Sep 30)

FY 2026 Apr update / Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism (D50-D89) / Coagulation defects, purpura and other hemorrhagic conditions (D65-D69)

D65

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Disseminated intravascular coagulation [defibrination syndrome]

A serious condition where blood clots form throughout the body while simultaneously bleeding occurs due to consumption of clotting factors.

Buddy Insight

Disseminated intravascular coagulation is a life-threatening condition involving systemic activation of the coagulation cascade, leading to simultaneous widespread thrombosis and hemorrhage.

CMS-HCC V28

N/A

—

Not risk-adjusted for this model/period.

Not mapped

CMS-HCC V24

Mapped

HCC 48

Coagulation Defects and Other...

RAF 0.192

ACA/HHS

Mapped

HCC 75

HHS-HCC 75

Varies by metal level

ESRD/PACE

Mapped

HCC 48

Coagulation Defects and Other...

RAF 0.063

RXHCC

N/A

—

Not risk-adjusted for this model/period.

Not mapped

Code Book Path

Official

D6Coagulation defects, purpura and other hemorrhagic conditions (D65-D69)

D65Disseminated intravascular coagulation [defibrination syndrome]

Inclusion Terms

Official

Afibrinogenemia, acquired
Consumption coagulopathy
COVID-19 associated diffuse or disseminated intravascular coagulopathy
Diffuse or disseminated intravascular coagulation [DIC]
Fibrinolytic hemorrhage, acquired

Excludes 2

Official

disseminated intravascular coagulation (complicating):
abortion or ectopic or molar pregnancy (O00-O07, O08.1)

Related Child Codes

Official

ICD-10-CM does not list child codes under D65 for this display context.

Includes

Official

ICD-10-CM does not list Includes notes for D65 in this effective period.

Excludes 1

Official

disseminated intravascular coagulation (complicating):
in newborn (P60)
pregnancy, childbirth and the puerperium (O45.0, O46.0, O67.0, O72.3)

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for D65 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for D65 in this effective period.

Code Also

Official

, if applicable, associated condition

Buddy Documentation Tip

HCC Buddy guidance

Document the underlying etiology triggering the DIC (sepsis, malignancy, trauma, obstetric emergency).

Record laboratory findings including platelet count, fibrinogen level, D-dimer, PT/INR, PTT, and fibrin degradation products.

Note whether the presentation is acute (hemorrhagic) or chronic (thrombotic), along with any end-organ damage.

MEAT Support

HCC Buddy guidance

Document the underlying etiology triggering the DIC (sepsis, malignancy, trauma, obstetric emergency).

Record laboratory findings including platelet count, fibrinogen level, D-dimer, PT/INR, PTT, and fibrin degradation products.

Note whether the presentation is acute (hemorrhagic) or chronic (thrombotic), along with any end-organ damage.

Audit Caution

HCC Buddy guidance

DIC should always have a documented underlying cause — code the underlying condition first per sequencing guidelines.

Do not assign D65 for isolated laboratory abnormalities without clinical DIC.

Avoid coding DIC when the clinical picture better fits a primary thrombophilia or isolated coagulation factor deficiency.

Common Mistakes

HCC Buddy guidance

D68.32 (Hemorrhagic disorder due to extrinsic circulating anticoagulants) — anticoagulant-related bleeding without systemic coagulation activation

D68.8 (Other specified coagulation defects) — lacks the consumptive coagulopathy hallmark

D69.6 (Thrombocytopenia, unspecified) — isolated low platelets without the full DIC picture.

Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.

Is D65 an HCC code?

Yes. D65 maps to Coagulation Defects and Other Specified Hematological Disorders under the V24 model but is not retained in V28.

HCC Category Mapping

V24HCC 48, Coagulation Defects and Other Specified Hematological Disorders

0.192

ESRDHCC 48, Coagulation Defects and Other Specified Hematological Disorders

0.063

Each model's RAF is its CMS base weight for that model's standard population, so weights are not directly comparable across models: CMS-HCC V28 and V24 use Community, Non-Dual, Aged; ESRD uses the dialysis continuing-enrollee model; RxHCC is the Part D continuing-enrollee, non-low-income, aged weight (a larger scale than CMS-HCC). ACA/HHS has no single weight — it varies by metal level. Actual per-patient RAF contribution depends on member segment, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains in use during the transition and for historical data.

Work D65 in the Code Book — tabular path, V28 RAF, and MEAT checklist →

MEAT Criteria for D65

For D65to count as a valid HCC diagnosis in a given encounter, the provider's documentation must show MEAT: Monitor, Evaluate, Assess, or Treat. A diagnosis from a prior year does not carry forward automatically, it has to be re-documented and supported each calendar year.

MMonitor: signs, symptoms, disease progression, or lab trending documented in the note
EEvaluate: test results, medication response, or physical findings reviewed by the provider
AAssess: explicit mention in the assessment or plan with acknowledgment of status
TTreat: medication, referral, procedure, therapy, or counseling tied to the diagnosis

Only one of M/E/A/T is required to support the code, but the documentation must be specific enough to show that the provider actually addressed D65 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

D65 is the ICD-10-CM diagnosis code for disseminated intravascular coagulation [defibrination syndrome]. A serious condition where blood clots form throughout the body while simultaneously bleeding occurs due to consumption of clotting factors. D65 sits in the ICD-10-CM chapter for diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism (d50-d89), within the section covering coagulation defects, purpura and other hemorrhagic conditions (d65-d69).

Under the older CMS-HCC V24 model, D65 maps to Coagulation Defects and Other Specified Hematological Disorders (HCC 48) with a community, non-dual, aged base RAF weight of 0.192. V28 is the CMS-HCC risk adjustment model that reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition.

Always identify and code the underlying cause (sepsis, trauma, malignancy, etc.). Because D65 maps to a payment HCC, the provider's documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's Medicare Advantage risk adjustment score. When documentation is ambiguous, coders should issue a provider query rather than assume the highest-specificity variant.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for D65 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Always identify and code the underlying cause (sepsis, trauma, malignancy, etc.)
•This is often an acute, life-threatening condition requiring immediate intervention

Clinical Significance

Disseminated intravascular coagulation is a life-threatening condition involving systemic activation of the coagulation cascade, leading to simultaneous widespread thrombosis and hemorrhage. It is always secondary to an underlying trigger such as sepsis, malignancy, trauma, or obstetric complications. Prompt identification and treatment of the underlying cause is critical, as DIC carries significant mortality.

Documentation Requirements

✓Document the underlying etiology triggering the DIC (sepsis, malignancy, trauma, obstetric emergency).
✓Record laboratory findings including platelet count, fibrinogen level, D-dimer, PT/INR, PTT, and fibrin degradation products.
✓Note whether the presentation is acute (hemorrhagic) or chronic (thrombotic), along with any end-organ damage.

Excludes 1, Do NOT code together

disseminated intravascular coagulation (complicating):
in newborn (P60)
pregnancy, childbirth and the puerperium (O45.0, O46.0, O67.0, O72.3)

Excludes 2, Not included here, may code separately

disseminated intravascular coagulation (complicating):
abortion or ectopic or molar pregnancy (O00-O07, O08.1)

Code Also

, if applicable, associated condition

Commonly Confused Codes

•D68.32 (Hemorrhagic disorder due to extrinsic circulating anticoagulants): anticoagulant-related bleeding without systemic coagulation activation
•D68.8 (Other specified coagulation defects): lacks the consumptive coagulopathy hallmark
•D69.6 (Thrombocytopenia, unspecified): isolated low platelets without the full DIC picture.

Code Hierarchy

└D65Disseminated intravascular coagulation [defibrination syndrome]

D65 ICD-10-CM Code: Disseminated intravascular coagulation [defibrination syndrome]

HCC Buddy Code Card

D65

Is D65 an HCC code?

HCC Category Mapping

MEAT Criteria for D65

Get the V28 RAF + MEAT cheat sheet

What This Code Means

Coding Tips

Clinical Significance

Documentation Requirements

Excludes 1, Do NOT code together

Excludes 2, Not included here, may code separately

Code Also

Commonly Confused Codes

Code Hierarchy

Work D65 in HCC Buddy