What is ICD-10 code D69.6?

D69.6 is the ICD-10-CM diagnosis code for Thrombocytopenia, unspecified. Low platelet count of unknown or unspecified cause. It belongs to the ICD-10-CM chapter for diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism (d50-d89). D69.6 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. D69.6 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. D69.6 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. D69.6 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 D69.6?

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. D69.6 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 D69.6?

Use only when the specific type of thrombocytopenia cannot be determined Attempt to investigate and assign a more specific code when additional information becomes available Because D69.6 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 D69.6: Thrombocytopenia, unspecified

ICD-10-CM Code View

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Code lookupD69.6Effective 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)

D69.6

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

Thrombocytopenia, unspecified

Low platelet count of unknown or unspecified cause.

Buddy Insight

Thrombocytopenia, unspecified, indicates a low platelet count without further characterization of the underlying cause.

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

N/A

—

Not risk-adjusted for this model/period.

Not mapped

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

D69Purpura and other hemorrhagic conditions

D69.6Thrombocytopenia, unspecified

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for D69.6 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for D69.6 in this effective period.

Related Child Codes

Official

D69.0Allergic purpura

D69.1Qualitative platelet defects

D69.2Other nonthrombocytopenic purpura

D69.3Immune thrombocytopenic purpura

D69.4Other primary thrombocytopenia

Includes

Official

ICD-10-CM does not list Includes notes for D69.6 in this effective period.

Excludes 1

Official

benign hypergammaglobulinemic purpura (D89.0)
cryoglobulinemic purpura (D89.1)
essential (hemorrhagic) thrombocythemia (D47.3)
hemorrhagic thrombocythemia (D47.3)
purpura fulminans (D65)

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for D69.6 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for D69.6 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for D69.6 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

Document the platelet count, clinical context in which thrombocytopenia was identified, current symptoms or bleeding manifestations, and the diagnostic workup plan.

Record medication review, peripheral blood smear findings, and any additional testing ordered (autoimmune markers, viral serologies, bone marrow biopsy).

MEAT Support

HCC Buddy guidance

Document the platelet count, clinical context in which thrombocytopenia was identified, current symptoms or bleeding manifestations, and the diagnostic workup plan.

Record medication review, peripheral blood smear findings, and any additional testing ordered (autoimmune markers, viral serologies, bone marrow biopsy).

Audit Caution

HCC Buddy guidance

Avoid prolonged use of this unspecified code — query the provider for specific etiology after appropriate workup.

Mild thrombocytopenia may be an incidental finding without clinical significance — do not code isolated lab values without clinical context.

Drug-induced thrombocytopenia, HIT, TTP, and HUS all have more specific codes.

Common Mistakes

HCC Buddy guidance

D69.3 (Immune thrombocytopenic purpura) — should be used when autoimmune etiology is confirmed

D69.42 (Congenital/hereditary thrombocytopenia) — when inherited cause is identified

D69.59 (Other secondary thrombocytopenia) — when a secondary cause is identified

D75.82x (Heparin-induced thrombocytopenia) — when HIT is diagnosed.

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 D69.6 an HCC code?

Yes. D69.6 maps to Coagulation Defects and Other Specified Hematological Disorders under the V24 model but is not retained in V28.

Code: D69.6
Description: Thrombocytopenia, 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 D69.6 in the Code Book — tabular path, V28 RAF, and MEAT checklist →

MEAT Criteria for D69.6

For D69.6 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 D69.6 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

D69.6 is the ICD-10-CM diagnosis code for thrombocytopenia, unspecified. Low platelet count of unknown or unspecified cause. D69.6 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, D69.6 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.

Use only when the specific type of thrombocytopenia cannot be determined. Because D69.6 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 D69.6 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Use only when the specific type of thrombocytopenia cannot be determined
•Attempt to investigate and assign a more specific code when additional information becomes available

Clinical Significance

Thrombocytopenia, unspecified, indicates a low platelet count without further characterization of the underlying cause. This code should serve as a temporary placeholder during diagnostic evaluation and be replaced with a more specific diagnosis once the etiology is determined. Persistent use of this unspecified code suggests incomplete diagnostic workup.

Documentation Requirements

✓Document the platelet count, clinical context in which thrombocytopenia was identified, current symptoms or bleeding manifestations, and the diagnostic workup plan.
✓Record medication review, peripheral blood smear findings, and any additional testing ordered (autoimmune markers, viral serologies, bone marrow biopsy).

Commonly Confused Codes

•D69.3 (Immune thrombocytopenic purpura): should be used when autoimmune etiology is confirmed
•D69.42 (Congenital/hereditary thrombocytopenia): when inherited cause is identified
•D69.59 (Other secondary thrombocytopenia): when a secondary cause is identified
•D75.82x (Heparin-induced thrombocytopenia): when HIT is diagnosed.