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D68.2

Billable

Hereditary deficiency of other clotting factors

Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)

Is D68.2 an HCC code?

Yes. D68.2 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

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

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 D68.2

For D68.2 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 D68.2 during that encounter — not just copy-forwarded from a problem list.

What This Code Means

D68.2 is the ICD-10-CM diagnosis code for hereditary deficiency of other clotting factors. An inherited bleeding disorder caused by deficiency of clotting factors other than factor VIII or IX (such as factors II, V, VII, X, XI, XII, or XIII). D68.2 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, D68.2 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, D68.2 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 which specific clotting factor is deficient in the documentation to ensure accurate coding. Because D68.2 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 D68.2 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • •Identify which specific clotting factor is deficient in the documentation to ensure accurate coding
  • •If a more specific code exists for the particular factor deficiency, use that instead of this general code

Clinical Significance

This code captures hereditary deficiencies of clotting factors other than VIII, IX, and XI, including rare conditions such as factor II (prothrombin), factor V, factor VII, factor X, factor XII, and factor XIII deficiencies. These are extremely rare autosomal recessive disorders, each with distinct bleeding phenotypes. Factor XII deficiency notably does not cause clinical bleeding despite prolonging the PTT.

Documentation Requirements

  • ✓Document the specific clotting factor that is deficient, the measured factor activity level, and whether the deficiency is homozygous or heterozygous.
  • ✓Record bleeding history, family history consistent with autosomal recessive inheritance, and treatment used for bleeding episodes or prophylaxis.

Commonly Confused Codes

D66 (Factor VIII deficiency) and D67 (Factor IX deficiency) — have their own specific codes and should not be coded hereD68.1 (Factor XI deficiency) — also has its own specific codeD68.4 (Acquired coagulation factor deficiency) — acquired rather than hereditary.

Code Hierarchy

└D68Other coagulation defects└D68.2Hereditary deficiency of other clotting factors
└D68.2Hereditary deficiency of other clotting factors

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