D68.03
BillableVon Willebrand disease, type 3
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is D68.03 an HCC code?
Yes. D68.03 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 D68.03
For D68.03 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 D68.03 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
D68.03 is the ICD-10-CM diagnosis code for von willebrand disease, type 3. A severe inherited bleeding disorder caused by complete or near-complete absence of von Willebrand factor protein, leading to significant bleeding risk. D68.03 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, D68.03 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, D68.03 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.
Type 3 is the most severe form; ensure documentation reflects the severity and absence or near-absence of von Willebrand factor. Because D68.03 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 D68.03 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Type 3 is the most severe form; ensure documentation reflects the severity and absence or near-absence of von Willebrand factor
- •Document treatment history including factor replacement therapy or desmopressin use to support the diagnosis
Clinical Significance
Von Willebrand disease type 3 is the most severe form, characterized by virtually complete absence of von Willebrand factor, resulting in very low factor VIII levels (typically <10%). Patients experience severe mucocutaneous bleeding and hemophilia-like joint and muscle bleeds. This rare autosomal recessive form accounts for less than 5% of VWD cases and requires regular prophylactic treatment.
Documentation Requirements
- ✓Document undetectable or severely reduced VWF antigen and activity levels, markedly low factor VIII, and absent VWF multimers.
- ✓Record frequency and severity of bleeding episodes including joint bleeds, current VWF/FVIII concentrate prophylaxis regimen, and any history of alloantibody development against VWF.