D69.4 ICD-10-CM Code: Other primary thrombocytopenia
HCC Buddy Code Card
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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)
D69.4
Header CodeICD-10-CMOfficial ICD-10-CMCodebook guidanceOther primary thrombocytopenia
Other primary thrombocytopenia
CMS-HCC V28
00
RAF 0
CMS-HCC V24
00
RAF 0
ACA/HHS
00
RAF 0
ESRD/PACE
00
RAF 0
RXHCC
00
RAF 0
Code Trumping
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Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for D69.4 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for D69.4 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for D69.4 in this effective period.
Excludes 1
Official- transient neonatal thrombocytopenia (P61.0)
- Wiskott-Aldrich syndrome (D82.0)
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for D69.4 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for D69.4 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for D69.4 in this effective period.
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.
What This Code Means
D69.4 is the ICD-10-CM diagnosis code for other primary thrombocytopenia. D69.4 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).
Header codes like D69.4 cannot be reported on claims directly, they organize child codes that share clinical context but the actual diagnosis must be coded to the highest level of specificity supported by the documentation. Coders should look at D69.4's child codes and select the one that matches the patient's documented presentation, since payers reject header codes submitted as the primary diagnosis. For risk adjustment workflows, header codes never contribute to a Medicare Advantage member's RAF score on their own; only billable child codes that happen to map to a payment HCC affect risk-adjusted plan payments.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for D69.4 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.