ICD-10 D68.4
Billable / Specific HCC v28: 48 CCAcquired coagulation factor deficiency
About ICD-10-CM D68.4
ICD-10-CM code D68.4 represents Acquired coagulation factor deficiency. This is a billable/specific code in the Blood and Blood-forming Organs chapter (block D68). The 2026 edition of ICD-10-CM D68.4 became effective on October 1, 2025.
Coding Tips for D68.4
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
D68.4 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.
D68.4 is designated CC for MS-DRG grouping. On inpatient claims, this code can shift the DRG to the with-CC variant when documented as a present-on-admission secondary diagnosis. Hospital CDI programs flag CC 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 D68.4. Per CMS ICD-10-CM Tabular 2026.
- Deficiency of coagulation factor due to liver disease
- Deficiency of coagulation factor due to vitamin K deficiency
Type 1 Excludes
Pure excludes, these codes can never be coded together with D68.4. The conditions are mutually exclusive (e.g., congenital vs acquired forms).
- vitamin K deficiency of newborn (P53)
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, CC
codes Acquired coagulation factor deficiency. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.
Medicare LCD Coverage for D68.4
Local Coverage Determinations (LCDs) from CMS MACs that list D68.4 as a covered diagnosis.
Showing top 10 of 38 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing D68.4.
5 Medicare
1 Aetna
CPT Codes Commonly Billed with D68.4
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
Convert D68.4 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 |
|---|---|---|
| D68.4 | 2867 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To D68.4
Other codes in section D65-D69 (Coagulation defects, purpura and other hemorrhagic conditions).
ICD-10 D68.4, Billing FAQ
Is ICD-10 code D68.4 billable? +
Yes, D68.4 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 D68.4? +
ICD-10 D68.4 includes: Deficiency of coagulation factor due to liver disease; Deficiency of coagulation factor due to vitamin K deficiency.
What codes are Type 1 Excludes for D68.4? +
Type 1 Excludes (never code together with D68.4): vitamin K deficiency of newborn (P53)
Does D68.4 affect Medicare Advantage HCC risk adjustment? +
Yes. D68.4 maps to CMS-HCC v28 category 48. Capture this diagnosis annually for accurate Medicare Advantage risk score.
Is D68.4 a CC or MCC for inpatient DRG? +
Yes, this code is designated as CC. Documenting as a secondary diagnosis on inpatient claims can shift the DRG to a higher-weighted category.
What CPT codes are commonly billed with D68.4? +
Procedures frequently paired with D68.4 include: J9190, J9260, J9215.
What ICD-9 codes does D68.4 map to? +
Per CMS GEMs, D68.4 maps to ICD-9 codes: 2867. 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 July 16, 2026.
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