ICDcodes.org
FY2027

D68.5 — Primary thrombophilia

Not billable

Is D68.5 billable?

No — D68.5 is a non-billable header code. D68.5 groups more specific codes and cannot be submitted on a claim. A valid ICD-10-CM code must be reported at the highest level of specificity available in its branch. Select one of the 3 billable codes beneath D68.5.

D68.5 at a glance

CodeD68.5
DescriptionPrimary thrombophilia
BillableNo — header code
Code setICD-10-CM FY2027
Valid for encountersOctober 1, 2026 – September 30, 2027

Excludes1 — never code together

The conditions below can never be reported together with D68.5 on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.

  • antiphospholipid syndrome (D68.61)
  • lupus anticoagulant (D68.62)
  • secondary activated protein C resistance (D68.69)
  • secondary antiphospholipid antibody syndrome (D68.69)
  • secondary lupus anticoagulant with hypercoagulable state (D68.69)
  • secondary systemic lupus erythematosus [SLE] inhibitor with hypercoagulable state (D68.69)
  • systemic lupus erythematosus [SLE] inhibitor finding without diagnosis (R76.0)
  • systemic lupus erythematosus [SLE] inhibitor with hemorrhagic disorder (D68.312)
  • thrombotic thrombocytopenic purpura (M31.19)

Inclusion terms

Alternative wording in documentation that is classified to D68.5.

  • Primary hypercoagulable states

Excludes1 — never code together — inherited from D68

The conditions below can never be reported together with D68.5 on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.

  • abnormal coagulation profile NOS (R79.1)

Excludes2 — not included here — inherited from Chapter 3

The conditions below are not part of D68.5, but a patient may have both at the same time. When documentation supports it, D68.5 and the excluded code may both be reported.

  • autoimmune disease (systemic) NOS (M35.9)
  • certain conditions originating in the perinatal period (P00-P96)
  • complications of pregnancy, childbirth and the puerperium (O00-O9A)
  • congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)
  • endocrine, nutritional and metabolic diseases (E00-E88)
  • human immunodeficiency virus [HIV] disease (B20)
  • injury, poisoning and certain other consequences of external causes (S00-T88)
  • neoplasms (C00-D49)
  • symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)

Excludes2 — not included here — inherited from D68

The conditions below are not part of D68.5, but a patient may have both at the same time. When documentation supports it, D68.5 and the excluded code may both be reported.

  • coagulation defects complicating abortion or ectopic or molar pregnancy (O00-O07, O08.1)
  • coagulation defects complicating pregnancy, childbirth and the puerperium (O45.0, O46.0, O67.0, O72.3)

What codes fall under D68.5? (3)

How long has D68.5 existed?

D68.5 has been in ICD-10-CM since at least FY2016, the earliest fiscal year on record here.

Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.

Which codes are confused with D68.5?

ICD-10-CM declares these codes mutually exclusive with D68.5 — exactly one of each pair can be correct for a given encounter.

What other codes are in the D68 family? (8)