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.

Which HCC does D65 map to under V28?

D65 has no payable CMS-HCC V28 mapping in the final FY2026 CMS file.

What RAF reference is published for D65?

D65 has no V28 reference coefficient because the final FY2026 source verifies no payable V28 mapping.

What is the V28 vs V24 difference for D65?

D65 has verified no payable V28 mapping in the final FY2026 source. Select a historical effective period before making any V24 comparison.

What documentation supports D65?

Always identify and code the underlying cause (sepsis, trauma, malignancy, etc.) This is often an acute, life-threatening condition requiring immediate intervention D65 is not a CMS-HCC V28 payment code in the verified current source, so MEAT is not the payment hook. Documentation still has to support the diagnosis if you report it.

Can D65 be a primary diagnosis?

Yes. D65 carries no code-first instruction in the FY2026 tabular, so it can be the first-listed diagnosis when it is the condition chiefly responsible for the encounter and the note supports it, and it can also be reported as a secondary diagnosis. For risk adjustment the order does not matter; the V28 category is the same either way.

Which codes cannot be reported with D65?

The Excludes1 note that applies to D65 lists disseminated intravascular coagulation (complicating): in newborn (P60); pregnancy, childbirth and the puerperium (O45.0, O46.0, O67.0, O72.3). An Excludes1 condition is not reported together with D65; report one or the other, unless the two conditions are unrelated, which the ICD-10-CM Official Guidelines (Section I.A.12.a) allow. The Excludes2 note lists disseminated intravascular coagulation (complicating): abortion or ectopic or molar pregnancy (O00-O07, O08.1); autoimmune disease (systemic) NOS (M35.9); certain conditions originating in the perinatal period (P00-P96); complications of pregnancy, childbirth and the puerperium (O00-O9A); and 6 more (see the notes on this page); those are separate conditions that may be reported together with D65 when both are documented.

2026 ICD-10-CM D65: Disseminated intravascular coagulation

D65 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · free HCC coding tools

ICD-10-CM Code View

HCC Buddy Code Card

Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.

Code lookupD65

Effective 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.

Overview Risk Models Code Book Documentation Audit Notes Edition comparison

CMS-HCC V28

N/A

—

Not risk-adjusted for this model/period.

Not mapped

CMS-HCC V24

Historical

Not used for standard CY2026 Medicare Advantage payment. Select a historical period to review V24.

Not used for CY2026 payment

ACA/HHS

Mapped

HCC 075

HHS-HCC 075 adult, RAF varies...

Code-level coefficient reference

ESRD/PACE

Mapped

HCC 48

Coagulation Defects and Other...

Code-level coefficient reference

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
Fibrinolytic purpura
Purpura fulminans

Excludes 2

Official

disseminated intravascular coagulation (complicating):
abortion or ectopic or molar pregnancy (O00-O07, O08.1)
autoimmune disease (systemic) NOS (M35.9)Inherited from D50-D89
certain conditions originating in the perinatal period (P00-P96)Inherited from D50-D89
complications of pregnancy, childbirth and the puerperium (O00-O9A)Inherited from D50-D89
congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)Inherited from D50-D89
endocrine, nutritional and metabolic diseases (E00-E88)Inherited from D50-D89
human immunodeficiency virus [HIV] disease (B20)Inherited from D50-D89
injury, poisoning and certain other consequences of external causes (S00-T88)Inherited from D50-D89
neoplasms (C00-D49)Inherited from D50-D89
symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)Inherited from D50-D89

Related Codes

Official

No related codes are included in this display for D65. Check the Code Book for the complete code path.

Includes

Official

No Includes notes are included in this display for D65. Check the code and parent instructions in the Code Book.

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

No Code First sequencing instructions are included in this display for D65. Check the code and parent instructions in the Code Book.

Use Additional

Official

No Use Additional Code instructions are included in this display for D65. Check the code and parent instructions in the Code Book.

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.

Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →

Is D65 an HCC code?

D65 is not in the CMS-HCC V28 or V24 community payment model. D65 has a separate mapping under the CMS-HCC ESRD model (HCC 48 (Coagulation Defects and Other Specified Hematological Disorders)); the applicable result needs member context. D65 also appears in the HHS-HCC commercial risk model (HCC 075 (HHS-HCC 075 adult, RAF varies by metal level)), which is a commercial market model rather than a Medicare Advantage payment mapping.

Code: D65
Description: Disseminated intravascular coagulation [defibrination syndrome]
HCC (V28): No CMS-HCC V28 mapping
RAF reference coefficient: —
Billable: Yes
Payment year: 2026

HCC Category Mapping

ESRDHCC 48, Coagulation Defects and Other Specified Hematological Disorders

Not separately weighted

These are source-labeled model coefficients, not member totals. A category may still be removed by hierarchy or model cleanup rules. 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 context, hierarchy and cleanup rules, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains available for historical review.

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

MEAT review for D65

For D65, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule.

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

Coder workflow notes

Get the V28 mapping + MEAT cheat sheet

One printable reference: check representative V28 mappings and the documentation reminders your note needs. Free, no card.

Free PDF. No card. Unsubscribe anytime.

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).

D65 has no mapping under the CMS-HCC V28 or V24 community payment models. D65 has a separate mapping under the CMS-HCC ESRD model (HCC 48 (Coagulation Defects and Other Specified Hematological Disorders)); the applicable result needs member context. D65 also appears in the HHS-HCC commercial risk model (HCC 075 (HHS-HCC 075 adult, RAF varies by metal level)), which is a commercial market model rather than a Medicare Advantage payment mapping. Do not assign V28 risk adjustment value from this page; verify the applicable model and payment year before using this code for risk adjustment.

Always identify and code the underlying cause (sepsis, trauma, malignancy, etc.).

HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, 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]

HCC Buddy Code Card

D65

Is D65 an HCC code?

HCC Category Mapping

MEAT review for D65

Get the V28 mapping + 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

More on D65

In the news

Work D65 in HCC Buddy

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

HCC Buddy Code Card

D65

Is D65 an HCC code?

HCC Category Mapping

MEAT review for D65

Get the V28 mapping + 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

More on D65

In the news

Work D65 in HCC Buddy