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D68.022 ICD-10-CM Code: Von Willebrand disease, type 2M

D68.022 maps to CMS-HCC V28 112 (RAF 0.450). Documentation must support MEAT. MEAT criteria · RAF calculator · HCC Buddy coding tools

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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)

D68.022

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Von Willebrand disease, type 2M

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

Buddy the Bee presenting code insight

Buddy Insight

Von Willebrand disease type 2M is characterized by decreased VWF-dependent platelet adhesion with a normal VWF multimer pattern, distinguishing it from Type 2A.

CMS-HCC V28

HCC 112

RAF 0.450

CMS-HCC V24

HCC 48

RAF 0.192

ACA/HHS

HCC 75

Varies by metal level

ESRD/PACE

HCC 48

RAF 0.063

RXHCC

N/A

Not mapped

Code Book Path

Official
D68.0Von Willebrand disease
D68.02Von Willebrand disease, type 2
D68.022Von Willebrand disease, type 2M

Inclusion Terms

Official
  • Qualitative defects of von Willebrand factor with defective platelet adhesion with a normal size distribution of von Willebrand factor multimers

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for D68.022 in this effective period.

Related Child Codes

Official
D68.020Von Willebrand disease, type 2A
D68.021Von Willebrand disease, type 2B
D68.023Von Willebrand disease, type 2N
D68.029Von Willebrand disease, type 2, unspecified

Includes

Official

ICD-10-CM does not list Includes notes for D68.022 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for D68.022 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for D68.022 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for D68.022 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for D68.022 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance
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.

MEAT Support

HCC Buddy guidance
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.

Audit Caution

HCC Buddy guidance
Type 2M may be misclassified as Type 1 if multimer analysis is not performed, since both can show reduced VWF levels.
The key distinguishing feature is the disproportionately low VWF activity relative to antigen level with normal multimers.
Ensure the provider has specified the subtype based on complete testing.

Common Mistakes

HCC Buddy guidance
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.

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 D68.022 an HCC code?

Yes. D68.022 (Von Willebrand disease, type 2M) maps to Immune Thrombocytopenia and Specified Coagulation Defects and Hemorrhagic Conditions under the CMS-HCC V28 risk adjustment model (and Coagulation Defects and Other Specified Hematological Disorders under V24), with a community non-dual aged RAF of 0.450. It is billable for payment year 2026.

Coder answer: D68.022 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
D68.022
Description
Von Willebrand disease, type 2M
HCC (V28)
HCC 112 — Immune Thrombocytopenia and Specified Coagulation Defects and Hemorrhagic Conditions
RAF
0.450
Billable
Yes
Payment year
2026

HCC Category Mapping

V28HCC 112, Immune Thrombocytopenia and Specified Coagulation Defects and Hemorrhagic Conditions
0.450
V24HCC 48, Coagulation Defects and Other Specified Hematological Disorders
0.192
ESRDHCC 48, Coagulation Defects and Other Specified Hematological Disorders
0.063

Each model's RAF is its CMS base weight for that model's standard population, so 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 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.

Work D68.022 in the Code Book — tabular path, V28 RAF, and MEAT checklist →

MEAT Criteria for D68.022

For D68.022 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 D68.022 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

D68.022 is the ICD-10-CM diagnosis code for von willebrand disease, type 2m. A bleeding disorder caused by abnormal von Willebrand factor protein (type 2M), affecting blood clotting through reduced platelet binding. D68.022 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, D68.022 maps to Immune Thrombocytopenia and Specified Coagulation Defects and Hemorrhagic Conditions (HCC 112) with a community, non-dual, aged base RAF weight of 0.450. Under the older CMS-HCC V24 model, D68.022 maps to Coagulation Defects and Other Specified Hematological Disorders (HCC 48) with a community, non-dual, aged base RAF weight of 0.192. 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.

Confirm type 2M diagnosis is explicitly stated in documentation; this type involves defective platelet-binding function. Because D68.022 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 D68.022 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

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.

Child Codes

Code Hierarchy

D68.022 code history

Code setChange
FY2023 (effective Oct 1, 2022)Added to the code set

Source: official CMS ICD-10-CM order and addenda files, FY2016 through FY2027.

Because D68.022 maps to a payment HCC, the documentation must also satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's risk adjustment score.

D68.022 maps to CMS-HCC V28 category 112, Immune Thrombocytopenia and Specified Coagulation Defects and Hemorrhagic Conditions. See the ICD-10 to HCC mapping hub for how the V28 crosswalk works. Because D68.022 carries a payment HCC, you can see what it adds to a RAF score and check the documentation the chart needs before it is submitted.

Work D68.022 in HCC Buddy

Open D68.022 in the Code Book for the full Index-to-Tabular path, MEAT checklist, and V28 HCC mapping, or in the Encoder to code from a keyword search. Pro includes 7 days to try everything, no card required.