D68.020

HCC Category Mapping

What This Code Means

Von Willebrand disease type 2A is a bleeding disorder where the body produces an abnormal form of a protein needed for blood clotting, resulting in prolonged bleeding from minor injuries or spontaneous bleeding. This is a moderately severe form of the condition that affects how blood platelets function.

Coding Tips

• •Verify the specific type of Von Willebrand disease (type 1, 2A, 2B, 2M, 2N, or type 3) is documented in the medical record before assigning this code, as each type has a distinct ICD-10-CM code
• •Look for associated bleeding manifestations (epistaxis, menorrhagia, GI bleeding) that may be coded separately if they are significant clinical concerns being managed

Clinical Significance

Von Willebrand disease type 2A is characterized by a qualitative defect in von Willebrand factor with selective loss of high-molecular-weight VWF multimers, leading to impaired platelet adhesion. Patients typically present with moderate to severe mucocutaneous bleeding. Unlike Type 1, most Type 2A patients do not respond adequately to desmopressin.

Documentation Requirements

• ✓Document VWF multimer analysis showing loss of high-molecular-weight multimers, reduced VWF activity disproportionate to VWF antigen levels, and factor VIII levels.
• ✓Record the specific genetic mutation if identified, DDAVP challenge results, and treatment plan including VWF-containing concentrates when needed.

Commonly Confused Codes