ICD-10 D69.3
Billable / Specific HCC v28: 48 CCImmune thrombocytopenic purpura
About ICD-10-CM D69.3
ICD-10-CM code D69.3 represents Immune thrombocytopenic purpura. This is a billable/specific code in the Blood and Blood-forming Organs chapter (block D69). The 2026 edition of ICD-10-CM D69.3 became effective on October 1, 2025.
Coding Tips for D69.3
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
D69.3 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.
D69.3 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 D69.3. Per CMS ICD-10-CM Tabular 2026.
- Hemorrhagic (thrombocytopenic) purpura
- Idiopathic thrombocytopenic purpura
- Tidal platelet dysgenesis
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 Immune thrombocytopenic purpura. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.
Medicare LCD Coverage for D69.3
Local Coverage Determinations (LCDs) from CMS MACs that list D69.3 as a covered diagnosis.
Showing top 10 of 208 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing D69.3.
2 Cigna
5 Medicare
CPT Codes Commonly Billed with D69.3
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
- J0840 CMS LCD: Billing and Coding: Immune Globulins CMS LCD
- J0850 CMS LCD: Billing and Coding: Immune Globulins CMS LCD
- 90371 CMS LCD: Billing and Coding: Immune Globulins CMS LCD
- 90375 CMS LCD: Billing and Coding: Immune Globulins CMS LCD
- J1573 CMS LCD: Billing and Coding: Immune Globulins CMS LCD
- J1569 CMS LCD: Billing and Coding: Immune Globulins CMS LCD
- J1459 CMS LCD: Billing and Coding: Immune Globulins CMS LCD
- J1557 CMS LCD: Billing and Coding: Immune Globulins CMS LCD
- J1556 CMS LCD: Billing and Coding: Immune Globulins CMS LCD
- J1560 CMS LCD: Billing and Coding: Immune Globulins CMS LCD
Convert D69.3 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 |
|---|---|---|
| D69.3 | 28731 | 10000 |
| D69.3 | 28739 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To D69.3
Other codes in section D65-D69 (Coagulation defects, purpura and other hemorrhagic conditions).
ICD-10 D69.3, Billing FAQ
Is ICD-10 code D69.3 billable? +
Yes, D69.3 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 D69.3? +
ICD-10 D69.3 includes: Hemorrhagic (thrombocytopenic) purpura; Idiopathic thrombocytopenic purpura; Tidal platelet dysgenesis.
Does D69.3 affect Medicare Advantage HCC risk adjustment? +
Yes. D69.3 maps to CMS-HCC v28 category 48. Capture this diagnosis annually for accurate Medicare Advantage risk score.
Is D69.3 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 D69.3? +
Procedures frequently paired with D69.3 include: J0840, J0850, 90371, 90375, J1573.
What ICD-9 codes does D69.3 map to? +
Per CMS GEMs, D69.3 maps to ICD-9 codes: 28731, 28739. 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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