D66 vs D68
D66 and D68 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 D66
factor VIII deficiency with vascular defect (D68.0-)
D66
Hereditary factor VIII deficiency
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
- Classical hemophilia
- Deficiency factor VIII (with functional defect)
- Hemophilia NOS
- Hemophilia A
Indexed under
- Hemophilia (classical) (familial) (hereditary)
- Subhemophilia
- Arthropathy › hemophilic NEC
- Disease, diseased › bleeder's
- Hemophilia › A (classical) (familial) (hereditary)
D68
Other coagulation defects
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