D68.8 vs P53
D68.8 and P53 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 D68.8
hemorrhagic disease of newborn (P53)
D68.8
Other specified coagulation defects
BillableUnspecified
- 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
- COVID-19 associated coagulopathy
Indexed under
- Afibrinogenemia
- Fibrinogenopenia
- Hypofibrinogenemia
- Defect, defective › coagulation › specified type NEC
- Deficiency, deficient › coagulation NOS › specified NEC
P53
Hemorrhagic disease of newborn
Billable
- Chapter 16
- Certain conditions originating in the perinatal period
- Section
- P50-P61
Use when the record says
- Vitamin K deficiency of newborn
Indexed under
- Minot's disease, newborn (hemorrhagic disease)
- Disease, diseased › Minot's
- Morbus › hemorrhagicus neonatorum
- Deficiency, deficient › menadione › newborn
- Deficiency, deficient › thrombokinase › newborn
These two codes sit in different chapters of the Tabular List, which is usually the clearest signal that they describe different underlying processes rather than different degrees of the same one.
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