D75.828
BillableOther heparin-induced thrombocytopenia syndrome
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is D75.828 an HCC code?
Yes. D75.828 maps to Coagulation Defects and Other Specified Hematological Disorders under the V24 model but is not retained in V28.
HCC Category Mapping
RAF weights shown are the community, non-dual, aged base weights from the CMS risk adjustment model file. 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.
MEAT Criteria for D75.828
For D75.828to 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 D75.828 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
D75.828 is the ICD-10-CM diagnosis code for other heparin-induced thrombocytopenia syndrome. Other specified types of heparin-induced thrombocytopenia that don't fit into the standard immune or non-immune categories. D75.828 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, D75.828 maps to Coagulation Defects and Other Specified Hematological Disorders (HCC 48) with a community, non-dual, aged base RAF weight of 0.209. 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 this code only when the specific type of HIT is documented but doesn't match D75.821 or D75.822. Because D75.828 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 D75.828 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
Clinical Significance
Other heparin-induced thrombocytopenia syndrome represents atypical presentations of platelet-mediated immune responses to heparin that do not fit the classic immune-mediated (type II) or non-immune (type I) classification. These variants can still carry significant thrombotic risk and require careful hematologic management including immediate heparin cessation and alternative anticoagulation.
Documentation Requirements
- ✓Documentation must specify the atypical mechanism or presentation distinguishing this from immune-mediated (D75.821) or non-immune (D75.822) heparin-induced thrombocytopenia.
- ✓Include platelet count trends with nadir values, timing relative to heparin exposure, anti-platelet factor 4 antibody test results, and the specific clinical rationale for classifying this as an 'other' type.
- ✓Document current and alternative anticoagulation therapy.
Commonly Confused Codes
- •D75.821 (heparin-induced thrombocytopenia, immune-mediated type II, which involves anti-PF4 antibodies), D75.822 (non-immune heparin-induced thrombocytopenia, type I, which is benign and self-limiting), D75.829 (unspecified heparin-induced thrombocytopenia when type cannot be determined), D69.59 (other secondary thrombocytopenia not related to heparin).