D68.52

Billable

Prothrombin gene mutation

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 genetic mutation in the prothrombin gene that increases the tendency for blood clots to form abnormally.

Coding Tips

•This is an inherited condition; document genetic testing results and family history in the medical record
•Often found in patients with recurrent venous thromboembolism; code the thrombotic event separately

Clinical Significance

Prothrombin gene mutation (G20210A) is the second most common inherited thrombophilia, present in approximately 2-3% of Caucasian populations. Heterozygous carriers have a 2-3 fold increased risk of venous thromboembolism due to elevated prothrombin levels. The risk is amplified when combined with other thrombophilic conditions or environmental risk factors such as oral contraceptive use.

Documentation Requirements

✓Document genetic confirmation of the prothrombin G20210A mutation, zygosity status, prothrombin activity levels if measured, and personal/family history of venous thromboembolism.
✓Record whether the patient is on long-term anticoagulation and the indication, and any combined thrombophilic states.

Commonly Confused Codes

D68.51 (Activated protein C resistance/Factor V Leiden) — different genetic thrombophilia that is more common D68.59 (Other primary thrombophilia) — for inherited thrombophilias beyond Factor V Leiden and prothrombin mutation D68.2 (Hereditary deficiency of other clotting factors) — factor deficiencies causing bleeding, not thrombosis.

Code Hierarchy

└D68Other coagulation defects └D68.5Primary thrombophilia └D68.52Prothrombin gene mutation

└D68.52Prothrombin gene mutation