What is ICD-10 code D68.9?

D68.9 is the ICD-10-CM diagnosis code for Coagulation defect, unspecified. A blood clotting disorder that is present but the specific type or cause has not been determined or documented. D68.9 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. D68.9 is part of the FY2026 ICD-10-CM code set published by the CMS National Center for Health Statistics and used on Medicare, Medicaid, and commercial claims in the United States.

Yes. D68.9 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. D68.9 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

What is the V28 vs V24 difference for D68.9?

CMS phased in the V28 risk adjustment model over payment years 2024 (33%), 2025 (67%), and 2026 (100%), replacing V24. V28 consolidates HCC categories, removes some lower-acuity conditions, and recalibrates RAF weights across the entire model. D68.9 was a payment HCC under V24 (Coagulation Defects and Other Specified Hematological Disorders) but the V28 recalibration removed it from the risk adjustment model. Both models can still appear in legacy data and in payer-specific lookback periods.

What should coders know when reporting D68.9?

This is a non-specific code; use only when the type of coagulation defect cannot be determined from available documentation Query the provider for more specific diagnosis information to allow for more precise coding Because D68.9 maps to a payment HCC, the documentation must also satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's risk adjustment score.

2026 ICD-10-CM D68.9: Coagulation defect

ICD-10-CM Code View

HCC Buddy Code Card

Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.

Code lookupD68.9Effective periodFY2026 Apr Update (Apr 1-Sep 30)

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)

D68.9

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Coagulation defect, unspecified

A blood clotting disorder that is present but the specific type or cause has not been determined or documented.

Buddy Insight

Coagulation defect, unspecified, is a nonspecific code indicating an identified but uncharacterized coagulation abnormality.

CMS-HCC V28

N/A

—

Not risk-adjusted for this model/period.

Not mapped

CMS-HCC V24

Mapped

HCC 48

Coagulation Defects and Other...

RAF 0.192

ACA/HHS

Mapped

HCC 75

HHS-HCC 75

Varies by metal level

ESRD/PACE

Mapped

HCC 48

Coagulation Defects and Other...

RAF 0.063

RXHCC

N/A

—

Not risk-adjusted for this model/period.

Not mapped

Code Book Path

Official

D68Other coagulation defects

D68.9Coagulation defect, unspecified

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for D68.9 in this effective period.

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

Official

D68.0Von Willebrand disease

D68.1Hereditary factor XI deficiency

D68.2Hereditary deficiency of other clotting factors

D68.3Hemorrhagic disorder due to circulating anticoagulants

D68.4Acquired coagulation factor deficiency

Includes

Official

ICD-10-CM does not list Includes notes for D68.9 in this effective period.

Excludes 1

Official

abnormal coagulation profile NOS (R79.1)

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for D68.9 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for D68.9 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for D68.9 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

Document the clinical presentation suggesting a coagulation defect (abnormal bleeding, abnormal coagulation studies), initial laboratory findings (PT, aPTT, platelet count, fibrinogen), and the plan for further diagnostic workup.

When the specific defect is identified, update the diagnosis code accordingly.

MEAT Support

HCC Buddy guidance

When the specific defect is identified, update the diagnosis code accordingly.

Audit Caution

HCC Buddy guidance

This unspecified code should not persist through multiple encounters — query the provider for more specific diagnosis after appropriate testing.

An isolated abnormal aPTT or PT without clinical significance may not warrant any coagulation defect code.

Avoid using this code as a chronic diagnosis when a specific coagulopathy has been identified.

Common Mistakes

HCC Buddy guidance

D68.8 (Other specified coagulation defects) — provides more specificity

D66-D68.2 (Specific factor deficiencies) — should be used when the deficient factor is identified

D69.9 (Hemorrhagic condition, unspecified) — even more vague and less appropriate if a coagulation defect is suspected.

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 D68.9 an HCC code?

Yes. D68.9 maps to Coagulation Defects and Other Specified Hematological Disorders under the V24 model but is not retained in V28.

Code: D68.9
Description: Coagulation defect, unspecified
HCC (V28): No CMS-HCC V28 mapping
RAF: —
Billable: Yes
Payment year: 2026

HCC Category Mapping

V24HCC 48, Coagulation Defects and Other Specified Hematological Disorders

0.192

ESRDHCC 48, Coagulation Defects and Other Specified Hematological Disorders

0.063

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 D68.9 in the Code Book — tabular path, V28 RAF, and MEAT checklist →

MEAT Criteria for D68.9

For D68.9 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 D68.9 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

D68.9 is the ICD-10-CM diagnosis code for coagulation defect, unspecified. A blood clotting disorder that is present but the specific type or cause has not been determined or documented. D68.9 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, D68.9 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.

This is a non-specific code; use only when the type of coagulation defect cannot be determined from available documentation. Because D68.9 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 D68.9 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•This is a non-specific code; use only when the type of coagulation defect cannot be determined from available documentation
•Query the provider for more specific diagnosis information to allow for more precise coding

Clinical Significance

Coagulation defect, unspecified, is a nonspecific code indicating an identified but uncharacterized coagulation abnormality. This code is typically used during initial evaluation before definitive diagnosis or in settings where detailed coagulation workup has not been completed. It should prompt further diagnostic evaluation to achieve a more specific diagnosis.

Documentation Requirements

✓Document the clinical presentation suggesting a coagulation defect (abnormal bleeding, abnormal coagulation studies), initial laboratory findings (PT, aPTT, platelet count, fibrinogen), and the plan for further diagnostic workup.
✓When the specific defect is identified, update the diagnosis code accordingly.

Commonly Confused Codes

•D68.8 (Other specified coagulation defects): provides more specificity
•D66-D68.2 (Specific factor deficiencies): should be used when the deficient factor is identified
•D69.9 (Hemorrhagic condition, unspecified): even more vague and less appropriate if a coagulation defect is suspected.