ICD-10 D65
Billable / Specific HCC v28: 48 MCCDisseminated intravascular coagulation [defibrination syndrome]
About ICD-10-CM D65
ICD-10-CM code D65 represents Disseminated intravascular coagulation [defibrination syndrome]. This is a billable/specific code in the Blood and Blood-forming Organs chapter (block D65). The 2026 edition of ICD-10-CM D65 became effective on October 1, 2025.
Coding Tips for D65
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
D65 is a CMS-HCC v28 risk-adjustment code (category 48). To count for the patient Risk Adjustment Factor (RAF), document the diagnosis with MEAT language each calendar year: Monitored, Evaluated, Assessed, Treated. A diagnosis on the problem list alone does not satisfy CMS RADV audit standards. Include the diagnosis in the assessment with current status and current treatment plan.
D65 is designated MCC for MS-DRG grouping. On inpatient claims, this code can shift the DRG to the with-MCC variant when documented as a present-on-admission secondary diagnosis. Hospital CDI programs flag MCC opportunities during chart review. Failure to capture this code may leave 30 to 80 percent of the inpatient stay revenue unrealized.
Inclusion Terms / Approximate Synonyms
Clinical terms and conditions classified under D65. Per CMS ICD-10-CM Tabular 2026.
- Afibrinogenemia, acquired
- Consumption coagulopathy
- COVID-19 associated diffuse or disseminated intravascular coagulopathy
- Diffuse or disseminated intravascular coagulation [DIC]
- Fibrinolytic hemorrhage, acquired
- Fibrinolytic purpura
- Purpura fulminans
Type 1 Excludes
Pure excludes, these codes can never be coded together with D65. The conditions are mutually exclusive (e.g., congenital vs acquired forms).
- disseminated intravascular coagulation (complicating):
- abortion or ectopic or molar pregnancy (O00-O07, O08.1)
- in newborn (P60)
- pregnancy, childbirth and the puerperium (O45.0, O46.0, O67.0, O72.3)
Coding Notes
Code Also
- , if applicable, associated condition
Medicare Advantage HCC Impact
Capture this diagnosis annually for accurate risk adjustment. Missed HCC captures are the #1 revenue leak in Medicare Advantage risk programs.
Inpatient DRG Impact, MCC
codes Disseminated intravascular coagulation [defibrination syndrome]. As a Major Complication/Comorbidity (MCC), this can shift the DRG assignment to a higher-weighted category, substantial reimbursement impact.
Medicare LCD Coverage for D65
Local Coverage Determinations (LCDs) from CMS MACs that list D65 as a covered diagnosis.
Showing top 10. Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing D65.
2 Cigna
1 Medicare
CPT Codes Commonly Billed with D65
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.
Convert D65 to ICD-9-CM
Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.
| ICD-10 | ICD-9 | Mapping Flags |
|---|---|---|
| D65 | 2866 | 00000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To D65
Other codes in section D65-D69 (Coagulation defects, purpura and other hemorrhagic conditions).
ICD-10 D65, Billing FAQ
Is ICD-10 code D65 billable? +
Yes, D65 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
What other names or terms map to D65? +
ICD-10 D65 includes: Afibrinogenemia, acquired; Consumption coagulopathy; COVID-19 associated diffuse or disseminated intravascular coagulopathy, and 4 more clinical synonyms.
What codes are Type 1 Excludes for D65? +
Type 1 Excludes (never code together with D65): disseminated intravascular coagulation (complicating):; abortion or ectopic or molar pregnancy (O00-O07, O08.1); in newborn (P60)
Does D65 affect Medicare Advantage HCC risk adjustment? +
Yes. D65 maps to CMS-HCC v28 category 48. Capture this diagnosis annually for accurate Medicare Advantage risk score.
Is D65 a CC or MCC for inpatient DRG? +
Yes, this code is designated as MCC. Documenting as a secondary diagnosis on inpatient claims can shift the DRG to a higher-weighted category.
What ICD-9 codes does D65 map to? +
Per CMS GEMs, D65 maps to ICD-9 codes: 2866. Useful for legacy data review and historical claim analysis.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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