ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 D68.51

Billable / Specific HCC v28: 48 CC

Activated protein C resistance

D68
Block
1
Synonyms
18
LCDs
7
Payer Policies
5
Linked CPTs

About ICD-10-CM D68.51

ICD-10-CM code D68.51 represents Activated protein C resistance. This is a billable/specific code in the Blood and Blood-forming Organs chapter (block D68). The 2026 edition of ICD-10-CM D68.51 became effective on October 1, 2025.

Coding Tips for D68.51

Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.

HCC capture: document with MEAT each year

D68.51 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.

Inpatient DRG impact: CC

D68.51 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 D68.51. Per CMS ICD-10-CM Tabular 2026.

  • Factor V Leiden mutation

Medicare Advantage HCC Impact

CMS-HCC v28 (current)
Category 48
ESRD-HCC
Category 48
RxHCC (Part D)
Category 48

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 Activated protein C resistance. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.

Medicare LCD Coverage for D68.51

Local Coverage Determinations (LCDs) from CMS MACs that list D68.51 as a covered diagnosis.

18 LCDs

Showing top 10 of 18 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Flow Cytometry
Article ID: 56464, Effective: 2026-03-05 00:00:00, 1361 covered, 0 non-covered
CPT 88189 →
CMS LCD: Billing and Coding: Flow Cytometry
Article ID: 56464, Effective: 2026-03-05 00:00:00, 1361 covered, 0 non-covered
CPT 86360 →
CMS LCD: Billing and Coding: Flow Cytometry
Article ID: 56464, Effective: 2026-03-05 00:00:00, 1361 covered, 0 non-covered
CPT 86361 →
CMS LCD: Billing and Coding: Flow Cytometry
Article ID: 56464, Effective: 2026-03-05 00:00:00, 1361 covered, 0 non-covered
CPT 88187 →
CMS LCD: Billing and Coding: Flow Cytometry
Article ID: 56464, Effective: 2026-03-05 00:00:00, 1361 covered, 0 non-covered
CPT 86359 →
CMS LCD: Billing and Coding: Flow Cytometry
Article ID: 56464, Effective: 2026-03-05 00:00:00, 1361 covered, 0 non-covered
CPT 86356 →
CMS LCD: Billing and Coding: Flow Cytometry
Article ID: 56464, Effective: 2026-03-05 00:00:00, 1361 covered, 0 non-covered
CPT 88188 →
CMS LCD: Billing and Coding: Flow Cytometry
Article ID: 56464, Effective: 2026-03-05 00:00:00, 1361 covered, 0 non-covered
CPT 88184 →
CMS LCD: Billing and Coding: Flow Cytometry
Article ID: 56464, Effective: 2026-03-05 00:00:00, 1361 covered, 0 non-covered
CPT 88185 →
CMS LCD: Billing and Coding: Flow Cytometry
Article ID: 56464, Effective: 2026-03-05 00:00:00, 1361 covered, 0 non-covered
CPT 86367 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing D68.51.

7 policies

1 Cigna

Flow Cytometry - (0538)
Policy ID: MM_0538

2 Medicare

Billing and Coding: Flow Cytometry
Policy ID: ART-56464
Billing and Coding: Non-Invasive Peripheral Venous Vascular and Hemodialysis Access Studies
Policy ID: ART-57594

4 Aetna

Prothrombin Time (INR) Home Testing Devices
Policy ID: CPB-0173
Parenteral Immunoglobulins
Policy ID: CPB-0206
Low-Molecular-Weight Heparins and Thrombin Inhibitors
Policy ID: CPB-0346
Polymerase Chain Reaction Testing: Selected Indications
Policy ID: CPB-0650

CPT Codes Commonly Billed with D68.51

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

5 linkages
  • 93970 Duplex venous extremity — DVT, venous thrombosis, edema, limb pain, personal hx DVT, thrombophilia Cardiology
  • 71260 CT chest with contrast — pulmonary embolism, chest pain, dyspnea, wheezing, pulmonary HTN, lung cancer, nodule, thrombophilia Radiology
  • 93990 CMS LCD: Billing and Coding: Non-Invasive Peripheral Venous Vascular and Hemodialysis Access Studies CMS LCD
  • 93985 CMS LCD: Billing and Coding: Non-Invasive Peripheral Venous Vascular and Hemodialysis Access Studies CMS LCD
  • 93986 CMS LCD: Billing and Coding: Non-Invasive Peripheral Venous Vascular and Hemodialysis Access Studies CMS LCD

Convert D68.51 to ICD-9-CM

Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.

ICD-10ICD-9Mapping Flags
D68.51 28981 10000

Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).

ICD-10 D68.51, Billing FAQ

Is ICD-10 code D68.51 billable? +

Yes, D68.51 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 D68.51? +

ICD-10 D68.51 includes: Factor V Leiden mutation.

Does D68.51 affect Medicare Advantage HCC risk adjustment? +

Yes. D68.51 maps to CMS-HCC v28 category 48. Capture this diagnosis annually for accurate Medicare Advantage risk score.

Is D68.51 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 D68.51? +

Procedures frequently paired with D68.51 include: 93970, 71260, 93990, 93985, 93986.

What ICD-9 codes does D68.51 map to? +

Per CMS GEMs, D68.51 maps to ICD-9 codes: 28981. 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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