D68.022

Billable

Von Willebrand disease, type 2M

HCC Category Mapping

V28HCC 112 — Von Willebrand Disease and Other Coagulation Defects

0.247

V24HCC 48 — Coagulation Defects and Other Specified Hematological Disorders

0.209

ESRDHCC 48 — Coagulation Defects and Other Specified Hematological Disorders

0.000

What This Code Means

A bleeding disorder caused by abnormal von Willebrand factor protein (type 2M), affecting blood clotting through reduced platelet binding.

Coding Tips

•Confirm type 2M diagnosis is explicitly stated in documentation; this type involves defective platelet-binding function
•Link to relevant lab findings such as reduced ristocetin cofactor activity to justify the specific type classification

Clinical Significance

Von Willebrand disease type 2M is characterized by decreased VWF-dependent platelet adhesion with a normal VWF multimer pattern, distinguishing it from Type 2A. The qualitative defect reduces VWF's ability to bind platelets despite producing normal-sized multimers. Patients typically present with moderate mucocutaneous bleeding.

Documentation Requirements

✓Document VWF activity disproportionately reduced compared to VWF antigen (low activity-to-antigen ratio), normal multimer distribution on analysis, and factor VIII levels.
✓Record genetic mutation data if available and DDAVP response testing, as some Type 2M patients may respond to desmopressin.

Commonly Confused Codes

D68.020 (Type 2A) — also shows reduced VWF activity but has abnormal multimer pattern D68.01 (Type 1) — may be confused when VWF levels are mildly reduced, but Type 2M has disproportionate activity reduction D68.023 (Type 2N) — different mechanism affecting factor VIII binding.

Code Hierarchy

└D68Other coagulation defects └D68.0Von Willebrand disease └D68.02Von Willebrand disease, type 2 └D68.022Von Willebrand disease, type 2M

└D68.022Von Willebrand disease, type 2M