D68.021
BillableVon Willebrand disease, type 2B
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is D68.021 an HCC code?
Yes. D68.021 maps to Von Willebrand Disease and Other Coagulation Defects under the CMS-HCC V28 risk adjustment model (and Coagulation Defects and Other Specified Hematological Disorders under V24).
HCC Category Mapping
RAF weights shown are the community, non-dual, aged base weights from the CMS risk adjustment model file. 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.
MEAT Criteria for D68.021
For D68.021 to 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 D68.021 during that encounter — not just copy-forwarded from a problem list.
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 Von Willebrand Disease and Other Coagulation Defects (HCC 112) with a community, non-dual, aged base RAF weight of 0.247. Under the older CMS-HCC V24 model, D68.021 maps to Coagulation Defects and Other Specified Hematological Disorders (HCC 48) with a community, non-dual, aged base RAF weight of 0.209. 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.
Verify the specific type 2B diagnosis is documented; type 2B has distinct platelet-binding abnormalities that differentiate it from other type 2 variants. Because D68.021 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 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.