D68.04
BillableAcquired von Willebrand disease
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is D68.04 an HCC code?
Yes. D68.04 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 D68.04
For D68.04 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 D68.04 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
D68.04 is the ICD-10-CM diagnosis code for acquired von willebrand disease. A bleeding disorder caused by von Willebrand factor deficiency that develops later in life due to underlying conditions, rather than being inherited from birth. D68.04 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, D68.04 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, D68.04 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.
Identify and document the underlying cause (such as lymphoproliferative disorders, autoimmune conditions, or medications) when possible. Because D68.04 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 D68.04 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Identify and document the underlying cause (such as lymphoproliferative disorders, autoimmune conditions, or medications) when possible
- •Distinguish from hereditary von Willebrand disease by confirming the acquired nature and onset in adulthood or secondary to another condition
Clinical Significance
Acquired von Willebrand disease develops in previously healthy individuals secondary to an underlying condition such as lymphoproliferative disorders, myeloproliferative neoplasms, cardiovascular disease (especially aortic stenosis), autoimmune disorders, or hypothyroidism. Unlike hereditary VWD, it typically presents later in life without family bleeding history. Treatment targets both the bleeding and the underlying cause.
Documentation Requirements
- ✓Document the underlying condition causing acquired VWD, absence of prior personal or family bleeding history, VWF antigen and activity levels, and multimer analysis.
- ✓Record response to treatment including DDAVP, VWF concentrates, IVIG, or treatment of the underlying disorder.
- ✓Note when the acquired nature was confirmed relative to the onset of symptoms.
Commonly Confused Codes
- •D68.00-D68.03 (Hereditary von Willebrand disease types) — acquired form develops later in life without family history
- •D68.311 (Acquired hemophilia) — autoantibodies against factor VIII rather than VWF dysfunction
- •D68.4 (Acquired coagulation factor deficiency) — broader category for acquired factor deficiencies.