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D75.821 ICD-10-CM Code: Non-immune heparin-induced thrombocytopenia

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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) / Other disorders of blood and blood-forming organs (D70-D77)

D75.821

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

Non-immune heparin-induced thrombocytopenia

A non-immune reaction to heparin medication that causes a dangerous drop in platelet count, typically occurring within days of heparin exposure.

Buddy the Bee presenting code insight

Buddy Insight

Non-immune heparin-induced thrombocytopenia (HIT Type I) is a benign, transient, non-immune-mediated drop in platelet count occurring within the first 2 days of heparin exposure.

CMS-HCC V28

N/A

Not mapped

CMS-HCC V24

HCC 48

RAF 0.192

ACA/HHS

HCC 75

Varies by metal level

ESRD/PACE

HCC 48

RAF 0.063

RXHCC

N/A

Not mapped

Code Book Path

Official
D75.8Other specified diseases of blood and blood-forming organs
D75.82Heparin induced thrombocytopenia (HIT)
D75.821Non-immune heparin-induced thrombocytopenia

Inclusion Terms

Official
  • Non-immune HIT
  • Type 1 heparin-induced thrombocytopenia

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for D75.821 in this effective period.

Related Child Codes

Official
D75.822Immune-mediated heparin-induced thrombocytopenia
D75.828Other heparin-induced thrombocytopenia syndrome
D75.829Heparin-induced thrombocytopenia, unspecified

Includes

Official

ICD-10-CM does not list Includes notes for D75.821 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for D75.821 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for D75.821 in this effective period.

Use Additional

Official
  • code, if applicable, for adverse effect of heparin (T45.515-)

Code Also

Official

ICD-10-CM does not list Code Also instructions for D75.821 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance
Document the temporal relationship between heparin initiation and platelet count decline (within 1-2 days), the degree of thrombocytopenia (mild), absence of thrombotic complications, and spontaneous resolution.
Record that immune-mediated HIT (Type II) was excluded based on timing, severity, and negative HIT antibody testing if performed.

MEAT Support

HCC Buddy guidance
Document the temporal relationship between heparin initiation and platelet count decline (within 1-2 days), the degree of thrombocytopenia (mild), absence of thrombotic complications, and spontaneous resolution.
Record that immune-mediated HIT (Type II) was excluded based on timing, severity, and negative HIT antibody testing if performed.

Audit Caution

HCC Buddy guidance
Critical to distinguish from immune-mediated HIT (Type II) which is life-threatening.
Non-immune HIT (Type I) does NOT require heparin discontinuation, unlike Type II.
Use the 4Ts scoring system (Thrombocytopenia, Timing, Thrombosis, other causes) to differentiate.
Do not assign this code when HIT Type II is suspected — err on the side of D75.822 until ruled out.

Common Mistakes

HCC Buddy guidance
D75.822 (Immune-mediated heparin-induced thrombocytopenia/HIT Type II) — far more serious condition requiring immediate heparin cessation and alternative anticoagulation
D69.59 (Other secondary thrombocytopenia) — non-HIT drug-induced thrombocytopenia
D69.6 (Thrombocytopenia, unspecified) — less specific.

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 D75.821 an HCC code?

Yes. D75.821 maps to Coagulation Defects and Other Specified Hematological Disorders under the V24 model but is not retained in V28.

Code
D75.821
Description
Non-immune heparin-induced thrombocytopenia
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 D75.821 in the Code Book — tabular path, V28 RAF, and MEAT checklist →

MEAT Criteria for D75.821

For D75.821 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 D75.821 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

D75.821 is the ICD-10-CM diagnosis code for non-immune heparin-induced thrombocytopenia. A non-immune reaction to heparin medication that causes a dangerous drop in platelet count, typically occurring within days of heparin exposure. D75.821 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 other disorders of blood and blood-forming organs (d70-d77).

Under the older CMS-HCC V24 model, D75.821 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 code specifically indicates non-immune mechanism; do not use if immune-mediated HIT is documented. Because D75.821 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 D75.821 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • This code specifically indicates non-immune mechanism; do not use if immune-mediated HIT is documented
  • Document the type of heparin exposure (unfractionated vs. low-molecular-weight) when available

Clinical Significance

Non-immune heparin-induced thrombocytopenia (HIT Type I) is a benign, transient, non-immune-mediated drop in platelet count occurring within the first 2 days of heparin exposure. It is caused by direct heparin-platelet interaction and typically resolves spontaneously without heparin discontinuation. Platelet counts rarely fall below 100,000/mcL and no thrombotic complications occur.

Documentation Requirements

  • Document the temporal relationship between heparin initiation and platelet count decline (within 1-2 days), the degree of thrombocytopenia (mild), absence of thrombotic complications, and spontaneous resolution.
  • Record that immune-mediated HIT (Type II) was excluded based on timing, severity, and negative HIT antibody testing if performed.

Commonly Confused Codes

  • D75.822 (Immune-mediated heparin-induced thrombocytopenia/HIT Type II): far more serious condition requiring immediate heparin cessation and alternative anticoagulation
  • D69.59 (Other secondary thrombocytopenia): non-HIT drug-induced thrombocytopenia
  • D69.6 (Thrombocytopenia, unspecified): less specific.

Child Codes

Code Hierarchy

D75.821 code history

Code setChange
FY2023 (effective Oct 1, 2022)Added to the code set

Source: official CMS ICD-10-CM order and addenda files, FY2016 through FY2027.

Because D75.821 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.

Work D75.821 in HCC Buddy

Open D75.821 in the Code Book for the full Index-to-Tabular path, MEAT checklist, and V28 HCC mapping, or in the Encoder to code from a keyword search. Pro includes 7 days to try everything, no card required.