D68.312 ICD-10-CM Code: Antiphospholipid antibody with hemorrhagic disorder
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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)
D68.312
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceAntiphospholipid antibody with hemorrhagic disorder
A bleeding disorder caused by antiphospholipid antibodies that interfere with blood clotting and increase bleeding risk.
Buddy Insight
Antiphospholipid antibody with hemorrhagic disorder represents the uncommon scenario where antiphospholipid antibodies cause bleeding rather than the more typical thrombotic presentation.
CMS-HCC V28
00
RAF 0
CMS-HCC V24
MappedHCC 48
RAF 0.209
ACA/HHS
00
RAF 0
ESRD/PACE
MappedHCC 48
RAF 0.0
RXHCC
00
RAF 0
Code Trumping
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Code Book Path
Inclusion Terms
Official- Lupus anticoagulant (LAC) with hemorrhagic disorder
- Systemic lupus erythematosus [SLE] inhibitor with hemorrhagic disorder
Excludes 2
Official- 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)
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for D68.312 in this effective period.
Excludes 1
Official- 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)
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for D68.312 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for D68.312 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for D68.312 in this effective period.
Buddy Documentation Tip
MEAT Support
Audit Caution
Common Mistakes
Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.
Is D68.312 an HCC code?
Yes. D68.312 maps to Coagulation Defects and Other Specified Hematological Disorders under the V24 model but is not retained in V28.
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.
Work D68.312 in the Code Book — tabular path, V28 RAF, and MEAT checklist →
MEAT Criteria for D68.312
For D68.312to 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 D68.312 during that encounter, not just copy-forwarded from a problem list.
Coder workflow notes
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What This Code Means
D68.312 is the ICD-10-CM diagnosis code for antiphospholipid antibody with hemorrhagic disorder. A bleeding disorder caused by antiphospholipid antibodies that interfere with blood clotting and increase bleeding risk. D68.312 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 older CMS-HCC V24 model, D68.312 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.
Document the presence of antiphospholipid antibodies (lupus anticoagulant, anticardiolipin, or anti-beta-2 glycoprotein) confirmed by testing. Because D68.312 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 D68.312 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
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.