D68.312

Billable

Antiphospholipid antibody with hemorrhagic disorder

HCC Category Mapping

V24HCC 48 — Coagulation Defects and Other Specified Hematological Disorders

0.209

ESRDHCC 48 — Coagulation Defects and Other Specified Hematological Disorders

0.000

What This Code Means

A bleeding disorder caused by antiphospholipid antibodies that interfere with blood clotting and increase bleeding risk.

Coding Tips

•Document the presence of antiphospholipid antibodies (lupus anticoagulant, anticardiolipin, or anti-beta-2 glycoprotein) confirmed by testing
•Distinguish between thrombotic and hemorrhagic presentations; this code is specifically for hemorrhagic manifestations

Clinical Significance

Antiphospholipid antibody with hemorrhagic disorder represents the uncommon scenario where antiphospholipid antibodies cause bleeding rather than the more typical thrombotic presentation. This may occur when antiphospholipid antibodies bind to prothrombin causing hypoprothrombinemia, or when severe thrombocytopenia develops. The hemorrhagic presentation requires different management than typical antiphospholipid syndrome.

Documentation Requirements

✓Document positive antiphospholipid antibodies (anticardiolipin, anti-beta2 glycoprotein I, lupus anticoagulant), specific hemorrhagic manifestations, prothrombin levels if hypoprothrombinemia is suspected, and platelet count.
✓Record the underlying condition if secondary (systemic lupus erythematosus, other autoimmune disease) and treatment approach.

Excludes 1 — Do NOT code together

antiphospholipid antibody, finding without diagnosis (R76.0)
lupus anticoagulant (LAC) finding without diagnosis (R76.0)
systemic lupus erythematosus [SLE] inhibitor finding without diagnosis (R76.0)

Excludes 2 — Not included here, may code separately

antiphospholipid antibody syndrome (D68.61)
antiphospholipid antibody with hypercoagulable state (D68.61)
lupus anticoagulant (LAC) with hypercoagulable state (D68.62)
systemic lupus erythematosus [SLE] inhibitor with hypercoagulable state (D68.62)

Commonly Confused Codes

D68.61 (Antiphospholipid syndrome) — thrombotic presentation is far more common D68.62 (Lupus anticoagulant syndrome) — typically prothrombotic despite the misleading name D68.311 (Acquired hemophilia) — different autoantibody target (factor VIII vs. phospholipid-binding proteins).

Code Hierarchy

└D68Other coagulation defects └D68.3Hemorrhagic disorder due to circulating anticoagulants └D68.31Hemorrhagic disorder due to intrinsic circulating anticoagulants, antibodies, or inhibitors └D68.312Antiphospholipid antibody with hemorrhagic disorder

└D68.312Antiphospholipid antibody with hemorrhagic disorder