D68.32 ICD-10-CM Code: Hemorrhagic disorder due to extrinsic circulating anticoagulants
HCC Buddy Code Card
Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.
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)
D68.32
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceHemorrhagic disorder due to extrinsic circulating anticoagulants
A bleeding disorder caused by blood-thinning medications or substances that circulate in the bloodstream and interfere with normal clotting.
Buddy Insight
Hemorrhagic disorder due to extrinsic circulating anticoagulants captures bleeding complications from anticoagulant medications such as warfarin, heparin, direct oral anticoagulants, and other antithrombotic agents.
CMS-HCC V28
N/A—
Not mapped
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- Drug-induced hemorrhagic disorder
- Hemorrhagic disorder due to increase in anti-IIa
- Hemorrhagic disorder due to increase in anti-Xa
- Hyperheparinemia
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for D68.32 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for D68.32 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for D68.32 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for D68.32 in this effective period.
Use Additional
Official- code for adverse effect, if applicable, to identify drug (T45.515, T45.525)
Code Also
OfficialICD-10-CM does not list Code Also instructions for D68.32 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 D68.32 an HCC code?
Yes. D68.32 maps to Coagulation Defects and Other Specified Hematological Disorders under the V24 model but is not retained in V28.
- Code
- D68.32
- Description
- Hemorrhagic disorder due to extrinsic circulating anticoagulants
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF
- —
- 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 D68.32 in the Code Book — tabular path, V28 RAF, and MEAT checklist →
MEAT Criteria for D68.32
For D68.32to 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 D68.32 during that encounter, not just copy-forwarded from a problem list.
Coder workflow notes
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What This Code Means
D68.32 is the ICD-10-CM diagnosis code for hemorrhagic disorder due to extrinsic circulating anticoagulants. A bleeding disorder caused by blood-thinning medications or substances that circulate in the bloodstream and interfere with normal clotting. D68.32 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, D68.32 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.
Document the specific anticoagulant agent (warfarin, heparin, etc.) in the medical record for accurate coding. Because D68.32 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 D68.32 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Document the specific anticoagulant agent (warfarin, heparin, etc.) in the medical record for accurate coding
- •This code is used when anticoagulant therapy causes bleeding complications; link to the medication code if applicable
Clinical Significance
Hemorrhagic disorder due to extrinsic circulating anticoagulants captures bleeding complications from anticoagulant medications such as warfarin, heparin, direct oral anticoagulants, and other antithrombotic agents. This is a common clinical scenario given widespread anticoagulant use. It reflects the medication's intended mechanism causing unintended excessive anticoagulation and hemorrhage.
Documentation Requirements
- ✓Document the specific anticoagulant medication causing the hemorrhagic disorder, INR or anti-Xa level at the time of bleeding, the anatomic site and severity of hemorrhage, and reversal agent used (vitamin K, protamine, idarucizumab, andexanet alfa, PCC).
- ✓Record adverse effect coding with the appropriate T-code for the causative medication.
Commonly Confused Codes
- •D68.311 (Acquired hemophilia): autoimmune inhibitor, not medication-related
- •D68.318 (Other hemorrhagic disorder due to intrinsic anticoagulants): endogenous antibodies, not exogenous medications
- •T45.515A (Adverse effect of anticoagulants, initial encounter): external cause code that should be used alongside D68.32.