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D66

Billable

Hereditary factor VIII deficiency

HCC Category Mapping

V28HCC 111Hemophilia
0.565
V24HCC 46Severe Hematological Disorders
0.666
ESRDHCC 46Severe Hematological Disorders
0.000

What This Code Means

A hereditary bleeding disorder caused by deficiency or dysfunction of clotting factor VIII, commonly known as hemophilia A.

Coding Tips

  • Specify the severity level (mild, moderate, severe) if documented
  • Use additional codes for any complications such as inhibitor development

Clinical Significance

Hereditary factor VIII deficiency (Hemophilia A) is the most common severe inherited bleeding disorder, caused by deficient or defective clotting factor VIII. Severity correlates with factor VIII activity levels: severe (<1%), moderate (1-5%), or mild (5-40%). This condition requires lifelong factor replacement therapy and carries significant healthcare resource utilization with a high RAF weight.

Documentation Requirements

  • Document the severity level (severe, moderate, mild) based on factor VIII activity levels.
  • Record current treatment regimen including factor replacement products, dosing frequency, and whether the patient has developed inhibitors (antibodies to factor VIII).
  • Note any target joints, history of intracranial hemorrhage, and hepatitis/HIV status if applicable from prior blood product exposure.

Excludes 1 — Do NOT code together

  • factor VIII deficiency with vascular defect (D68.0-)

Commonly Confused Codes

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