D68.5 vs D68.69
D68.5 (Primary thrombophilia) compared with D68.69 (Other thrombophilia), from the official CMS tabular data. Do not report these codes together: the official tabular list marks them Excludes1.
Can these codes be reported together?
No — do not report together. D68.5 carries an Excludes1 note covering D68.69: “secondary activated protein C resistance (D68.69)”
Sole exception: when the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).
No — do not report together. D68.5 carries an Excludes1 note covering D68.69: “secondary antiphospholipid antibody syndrome (D68.69)”
Sole exception: when the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).
No — do not report together. D68.5 carries an Excludes1 note covering D68.69: “secondary lupus anticoagulant with hypercoagulable state (D68.69)”
Sole exception: when the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).
No — do not report together. D68.5 carries an Excludes1 note covering D68.69: “secondary systemic lupus erythematosus [SLE] inhibitor with hypercoagulable state (D68.69)”
Sole exception: when the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).
Side by side
| D68.5Primary thrombophilia | D68.69Other thrombophilia | |
|---|---|---|
| Billing status | Non-billable header | Billable |
| Classification | D50-D89 — Diseases of the Blood and Blood-forming Organs and Certain Disorders Involving the Immune Mechanism (D50-D89) | D50-D89 — Diseases of the Blood and Blood-forming Organs and Certain Disorders Involving the Immune Mechanism (D50-D89) |
| Definition | Primary thrombophilia is a non-billable ICD-10-CM category code (D68.5). | Other thrombophilia is a billable ICD-10-CM diagnosis code (D68.69). |
| Includes | Primary hypercoagulable states | COVID-19 associated hypercoagulability Hypercoagulable states NEC Secondary hypercoagulable state NOS |
Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources