D68.021 ICD-10-CM Code: Von Willebrand disease, type 2B
D68.021 maps to CMS-HCC V28 112. A source-labeled RAF reference is available. Confirm the documented diagnosis and applicable coding requirements. MEAT criteria · RAF Calculator · free HCC coding tools
HCC Buddy Code Card
Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.
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)
D68.021
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceVon Willebrand disease, type 2B
A bleeding disorder caused by abnormal von Willebrand factor protein (type 2B), which affects the blood's ability to clot properly.
Buddy Insight
Von Willebrand disease type 2B features a gain-of-function mutation in VWF that causes increased affinity for platelet glycoprotein Ib, leading to spontaneous VWF-platelet binding, consumption of large multimers, and often mild thrombocytopenia.
CMS-HCC V28
MappedHCC 112
Coefficient HCC 112: 0.450 (Community Non-Dual Aged (CNA))
CMS-HCC V24
HistoricalHistorical
Not used for CY2026 payment
ACA/HHS
MappedHCC 075
Code-level coefficient reference
ESRD/PACE
MappedHCC 48
Code-level coefficient reference
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
Official- Qualitative defects of von Willebrand factor with high-molecular-weight von Willebrand factor loss
- Qualitative defects of von Willebrand factor with hyper-adhesive forms
- Qualitative defects of von Willebrand factor with increased affinity for platelet glycoprotein lb
- Qualitative defects of von Willebrand factorInherited from D68.02
Excludes 2
Official- autoimmune disease (systemic) NOS (M35.9)Inherited from D50-D89, D68
- certain conditions originating in the perinatal period (P00-P96)Inherited from D50-D89, D68
- complications of pregnancy, childbirth and the puerperium (O00-O9A)Inherited from D50-D89, D68
- congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)Inherited from D50-D89, D68
- endocrine, nutritional and metabolic diseases (E00-E88)Inherited from D50-D89, D68
- human immunodeficiency virus [HIV] disease (B20)Inherited from D50-D89, D68
- injury, poisoning and certain other consequences of external causes (S00-T88)Inherited from D50-D89, D68
- neoplasms (C00-D49)Inherited from D50-D89, D68
- symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)Inherited from D50-D89, D68
- coagulation defects complicating abortion or ectopic or molar pregnancy (O00-O07, O08.1)Inherited from D50-D89, D68
- coagulation defects complicating pregnancy, childbirth and the puerperium (O45.0, O46.0, O67.0, O72.3)Inherited from D50-D89, D68
Related Codes
Includes
OfficialNo Includes notes are included in this display for D68.021. Check the code and parent instructions in the Code Book.
Excludes 1
Official- abnormal coagulation profile NOS (R79.1)Inherited from D68, D68.0
- capillary fragility (hereditary) (D69.8)Inherited from D68, D68.0
- factor VIII deficiency NOS (D66)Inherited from D68, D68.0
- factor VIII deficiency with functional defect (D66)Inherited from D68, D68.0
Code First
OfficialNo Code First sequencing instructions are included in this display for D68.021. Check the code and parent instructions in the Code Book.
Use Additional
OfficialNo Use Additional Code instructions are included in this display for D68.021. Check the code and parent instructions in the Code Book.
Code Also
OfficialNo Code Also instructions are included in this display for D68.021. Check the code and parent instructions in the Code Book.
Buddy Documentation Tip
MEAT Support
Audit Caution
Common Mistakes
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 D68.021 an HCC code?
Yes. D68.021 (Von Willebrand disease, type 2B) maps to HCC 112, Immune Thrombocytopenia and Specified Coagulation Defects and Hemorrhagic Conditions under the CMS-HCC V28 risk adjustment model, with a source-labeled community non-dual aged reference coefficient of 0.450. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes. It is billable for payment year 2026.
Coder answer: D68.021 is billable and maps to V28 HCC 112, Immune Thrombocytopenia and Specified Coagulation Defects and Hemorrhagic Conditions. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.
- Code
- D68.021
- Description
- Von Willebrand disease, type 2B
- HCC (V28)
- HCC 112 — Immune Thrombocytopenia and Specified Coagulation Defects and Hemorrhagic Conditions
- RAF reference coefficient
- 0.450
- Billable
- Yes
- Payment year
- 2026
HCC Category Mapping
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 D68.021 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →
MEAT review for D68.021
For D68.021, 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
D68.021 is the ICD-10-CM diagnosis code for von willebrand disease, type 2b. A bleeding disorder caused by abnormal von Willebrand factor protein (type 2B), which affects the blood's ability to clot properly. D68.021 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 CMS-HCC V28 risk adjustment model, D68.021 maps to Immune Thrombocytopenia and Specified Coagulation Defects and Hemorrhagic Conditions (HCC 112) with a source-labeled community, non-dual, aged reference coefficient of 0.450. No V24 mapping is shown for D68.021; use the applicable model and payment year when reviewing the V28 mapping. For CY2026 non-PACE Medicare Advantage, CMS uses 100% of the 2024 CMS-HCC model (V28). PACE uses a separate model blend. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes.
Verify the specific type 2B diagnosis is documented; type 2B has distinct platelet-binding abnormalities that differentiate it from other type 2 variants. For D68.021, 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. 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, source-labeled coefficient references, and MEAT documentation criteria for D68.021 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Verify the specific type 2B diagnosis is documented; type 2B has distinct platelet-binding abnormalities that differentiate it from other type 2 variants
- •Document any associated symptoms like mucosal bleeding, easy bruising, or prolonged bleeding times to support medical necessity
Clinical Significance
Von Willebrand disease type 2B features a gain-of-function mutation in VWF that causes increased affinity for platelet glycoprotein Ib, leading to spontaneous VWF-platelet binding, consumption of large multimers, and often mild thrombocytopenia. This unique pathophysiology makes desmopressin contraindicated as it can worsen thrombocytopenia. Patients may be misdiagnosed with immune thrombocytopenic purpura.
Documentation Requirements
- ✓Document enhanced ristocetin-induced platelet aggregation at low-dose ristocetin (characteristic finding), loss of high-molecular-weight multimers on analysis, platelet count trends, and genetic testing confirming Type 2B mutation.
- ✓Record why DDAVP is avoided and the VWF-containing concentrate used for treatment.
Commonly Confused Codes
- •D69.3 (Immune thrombocytopenic purpura): thrombocytopenia in Type 2B may lead to misdiagnosis
- •D68.020 (Type 2A): similar multimer loss but different mechanism and different DDAVP response
- •Platelet-type (pseudo) von Willebrand disease: mutation is in the platelet receptor, not VWF, and has a different code.