D65 vs D69
D65 and D69 can never be reported together. ICD-10-CM declares them mutually exclusive with an Excludes1 note, meaning the two conditions cannot occur in the same patient — so exactly one of them is correct for any given encounter.
The official note, declared on D69
purpura fulminans (D65)
D65
Disseminated intravascular coagulation [defibrination syndrome]
Billable
- Chapter 3
- Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism
- Section
- D65-D69
Use when the record says
- 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
Indexed under
- Defibrination (syndrome)
- Fibrinolysis (hemorrhagic) (acquired)
- Proteolysis, pathologic
- Afibrinogenemia › acquired
- Coagulation, intravascular › COVID-19 associated (diffuse) (disseminated)
D69
Purpura and other hemorrhagic conditions
Not billable
- Chapter 3
- Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism
- Section
- D65-D69
Excludes1 is not always absolute: where two conditions covered by the note are genuinely unrelated, CMS guidance permits reporting both. Document the reasoning rather than assuming it. More on Excludes1 vs Excludes2 · FY2027