D68.2 ICD-10-CM Code: Hereditary deficiency of other clotting factors
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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)
D68.2
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceHereditary 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).
Buddy Insight
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.
CMS-HCC V28
MappedHCC 112
RAF 0.450
CMS-HCC V24
MappedHCC 48
RAF 0.192
ACA/HHS
MappedHCC 75
Varies by metal level
ESRD/PACE
MappedHCC 48
RAF 0.063
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
Official- AC globulin deficiency
- Congenital afibrinogenemia
- Deficiency of factor I [fibrinogen]
- Deficiency of factor II [prothrombin]
- Deficiency of factor V [labile]
Excludes 2
Official- coagulation defects complicating abortion or ectopic or molar pregnancy (O00-O07, O08.1)
- coagulation defects complicating pregnancy, childbirth and the puerperium (O45.0, O46.0, O67.0, O72.3)
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for D68.2 in this effective period.
Excludes 1
Official- abnormal coagulation profile NOS (R79.1)
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for D68.2 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for D68.2 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for D68.2 in this effective period.
Buddy Documentation Tip
MEAT Support
Audit Caution
Common Mistakes
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 D68.2 an HCC code?
Yes. D68.2 (Hereditary deficiency of other clotting factors) 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: D68.2 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
- D68.2
- Description
- Hereditary deficiency of other clotting factors
- HCC (V28)
- HCC 112 — Immune Thrombocytopenia and Specified Coagulation Defects and Hemorrhagic Conditions
- RAF
- 0.450
- Billable
- Yes
- Payment year
- 2026
HCC Category Mapping
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 D68.2 in the Code Book — tabular path, V28 RAF, and MEAT checklist →
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.
Coder workflow notes
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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 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, D68.2 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.
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.