Skip to main content

D65 ICD-10-CM Code: Disseminated intravascular coagulation [defibrination syndrome]

Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Coding at a Glance

Tabular directives
7 inclusion terms · 3 Excludes1 · 2 Excludes2 · 1 code-also instruction
Risk adjustment
CMS-HCC V22 category 48

Inpatient Payment Groups (MS-DRG)

Potential MS-DRG participation — not a DRG assignment.

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v44, Appendix B.

  • MS-DRG 791 — PREMATURITY WITH MAJOR PROBLEMS (MDC 15)
  • MS-DRG 793 — FULL TERM NEONATE WITH MAJOR PROBLEMS (MDC 15)
  • MS-DRG 813 — COAGULATION DISORDERS (MDC 16)

A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for D65 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2027Effective: October 1, 2026

Trace:FY2027 changesChange historyRelease, file and checksum

Inclusion Terms

Alternative terms the tabular list files under this code.

  • 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

Excludes1 — Not Coded Here

Conditions generally not reported together with this code (Excludes1) -- an error unless the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Excludes2 — Not Included Here

Conditions not covered by this code, but which may be reported alongside it when both are present.

Code Also

Additional codes that may be required to fully describe the encounter.

  • Code also, if applicable, associated condition

Coder workflow for D65

MedCoder structured workflow — derived from this code’s own official record

Before you code D65

  1. Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with D65. Excludes1 conditions are not reported together with this code unless the record shows they are unrelated (Guidelines I.A.12.a).

    See the official tabular notes

Choose the right path

  1. Does the documentation support a condition named in D65’s Excludes1 note?
    Yes → Do not simply proceed: review the excluded code. Both are reported only when the record shows the two conditions are unrelated.
    No → Continue.

    ReviewP60, O45.0, O46.0, O67.0, O72.3

Consider D65. Then review the Code Also note, and confirm the code is valid for the date of service in the Verify section.

Documentation check

The provider’s diagnostic statement
Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).

Official instructions as workflow

  • Excludes1 — check before selecting D65(3 notes)

    Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with D65: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.

    CompareP60, O45.0, O46.0, O67.0, O72.3

    See the official tabular notes · Guidelines I.A.12.a

  • Excludes2 — not part of D65(2 notes)

    Coding workflow: The conditions named in this note are not included in D65. When the record documents both, both may be reported; the note is a boundary, not a prohibition.

    CompareO08.1

    See the official tabular notes · Guidelines I.A.12.b

  • Code Also — related condition(1 note)

    Coding workflow: Review the related condition when both are documented and the instruction applies. A Code Also note does not fix sequencing; the order follows the circumstances of the encounter.

    See the official tabular notes · Guidelines I.A.17

Coding decision scenarios

Pattern scenarios for this code’s structure — decision rules, not clinical cases

Documentation: Both the condition D65 describes and a condition named in its Excludes1 note are documented for the same encounter.

Coding question: Can both codes be reported?

Path: Review the Excludes1 note and the excluded code, and look for a provider statement on whether the two conditions are related.

Reason: Excludes1 means the two are not coded together; the exception is when the record shows the conditions are unrelated to each other (Guidelines I.A.12.a).

ReviewP60, O45.0, O46.0, O67.0, O72.3

Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.

Don’t confuse D65 with…

MedCoder analysis — pairs from this code’s official notes, distinctions written by MedCoder

The codes most likely to be picked instead of D65 — named in its own official notes, or sharing its laterality or encounter family — with what separates them and which documentation moves the case. Each links to the full comparison.

  • P60— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

    Not reported together with this code, except where the two conditions are documented as unrelated.

    What moves you there: Documentation of in newborn moves the case to P60; the two are not reported together unless documented as unrelated.

    Full comparison: D65 vs P60 →

  • O45.0— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

    Not reported together with this code, except where the two conditions are documented as unrelated.

    What moves you there: Documentation of pregnancy, childbirth and the puerperium moves the case to O45.0; the two are not reported together unless documented as unrelated.

    Full comparison: D65 vs O45.0 →

  • O46.0— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

    Not reported together with this code, except where the two conditions are documented as unrelated.

    What moves you there: Documentation of pregnancy, childbirth and the puerperium moves the case to O46.0; the two are not reported together unless documented as unrelated.

    Full comparison: D65 vs O46.0 →

  • O67.0— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

    Not reported together with this code, except where the two conditions are documented as unrelated.

    What moves you there: Documentation of pregnancy, childbirth and the puerperium moves the case to O67.0; the two are not reported together unless documented as unrelated.

    Full comparison: D65 vs O67.0 →

  • O72.3— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

    Not reported together with this code, except where the two conditions are documented as unrelated.

    What moves you there: Documentation of pregnancy, childbirth and the puerperium moves the case to O72.3; the two are not reported together unless documented as unrelated.

    Full comparison: D65 vs O72.3 →

  • O00— Excludes2 relationship (Informational)

    Distinct conditions — both may be reported.

    A distinct condition — both may be reported when both are documented.

    What moves you there: Documentation of abortion or ectopic or molar pregnancy adds O00; it is not part of this code and both may be reported when both are documented.

    Full comparison: D65 vs O00 →

Relationships are read from this code's own official notes, its laterality siblings and its encounter family; the wording of each distinction is MedCoder editorial, and the documentation named in each “what moves you there” line is the official note phrase or sibling title itself. Source: CMS ICD-10-CM tabular instructional notes; ICD-10-CM Official Guidelines, Section I.A.12.a.

Code Overview

Disseminated intravascular coagulation [defibrination syndrome] is a billable ICD-10-CM diagnosis code (D65).

MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.

Indexed Clinical Terms (20)

Official source data — entries quoted as published, in the Index’s own lookup phrasing

Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code. These are alphabetic-index entries shown as the Index writes them — lookup phrasing, not necessarily the wording of a final diagnosis.

Official Coding Guidelines

No excerpt in the ICD-10-CM Official Guidelines names this code specifically. Its chapter carries only this chapter-wide note:

Chapter 3: Disease of the blood and blood-forming organs and certain disorders involving the immune mechanism (D50-D89)

Reserved for future guideline expansion

Decision Points

The directives on this code's own record, as a pre-claim checklist.

  1. 1 Code Also note — a second code may apply; the guidelines leave its sequencing to the circumstances of the encounter. See the Code Also notes
  2. 3 Excludes1 entries — codes named there are generally not reported together with this code (Guidelines I.A.12.a). See the Excludes1 notes
  3. 2 Excludes2 entries — those conditions are not part of this code and may be reported additionally when documented. See the Excludes2 notes

Checklist rows are derived from this code's own official directives; the wording of each check is MedCoder editorial. The official notes themselves are in the sections each row links to.

Verify Before Coding

  • MCC as a secondary diagnosis (FY2027). Can raise the stay's MS-DRG severity tier.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.

Relationships & Classification

MedCoder structured relationships — computed from published CMS and AHRQ datasets

Other codes that name D65 or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.

Referenced by 2 Excludes1 notes: D68.6 — Other thrombophilia, D69 — Purpura and other hemorrhagic conditions.

These codes’ tabular lists mark this diagnosis as mutually exclusive — not reported together unless the conditions are documented as unrelated.

Referenced by 10 Excludes2 notes: R70 — Elevated erythrocyte sedimentation rate and abnormality of plasma viscosity, R70-R79 — Abnormal findings on examination of blood, without diagnosis (R70-R79), R71 — Abnormality of red blood cells, R73 — Elevated blood glucose level, R74 — Abnormal serum enzyme levels, R75 — Inconclusive laboratory evidence of human immunodeficiency virus [HIV], R76 — Other abnormal immunological findings in serum, R77 — Other abnormalities of plasma proteins, R78 — Findings of drugs and other substances, not normally found in blood, R79 — Other abnormal findings of blood chemistry.

These codes’ tabular lists name this diagnosis as distinct — both may be reported when both are documented.

Referenced by 22 Code First instructions across 2 chapters: N08 — Glomerular disorders in diseases classified elsewhere, T36 — Poisoning by, adverse effect of and underdosing of systemic antibiotics, T36-T39 — Antibiotics & Anti-infectives (T36-T39), T36-T50 — Poisoning by, adverse effects of and underdosing of drugs, medicaments and biological substances (T36-T50), T37 — Poisoning by, adverse effect of and underdosing of other systemic anti-infectives and antiparasitics, T38 — Poisoning by, adverse effect of and underdosing of hormones and their synthetic substitutes and antagonists, not elsewhere classified, T39 — Poisoning by, adverse effect of and underdosing of nonopioid analgesics, antipyretics and antirheumatics, T40 — Poisoning by, adverse effect of and underdosing of narcotics and psychodysleptics [hallucinogens], T40-T41 — Analgesics & Antipyretics (T40-T41), T41 — Poisoning by, adverse effect of and underdosing of anesthetics and therapeutic gases, T42 — Poisoning by, adverse effect of and underdosing of antiepileptic, sedative- hypnotic and antiparkinsonism drugs, T42-T43 — Anticonvulsants & Psychotropics (T42-T43), T43 — Poisoning by, adverse effect of and underdosing of psychotropic drugs, not elsewhere classified, T44 — Poisoning by, adverse effect of and underdosing of drugs primarily affecting the autonomic nervous system, T44-T46 — Cardiovascular & Gastrointestinal (T44-T46), T45 — Poisoning by, adverse effect of and underdosing of primarily systemic and hematological agents, not elsewhere classified, T46 — Poisoning by, adverse effect of and underdosing of agents primarily affecting the cardiovascular system, T47 — Poisoning by, adverse effect of and underdosing of agents primarily affecting the gastrointestinal system, T47-T50 — Hormones & Systemic Agents (T47-T50), T48 — Poisoning by, adverse effect of and underdosing of agents primarily acting on smooth and skeletal muscles and the respiratory system, +2 more.

Each of these codes carries a Code First note naming this condition — when that code is reported, THIS code is sequenced first, ahead of it.

Referenced by 4 Use Additional Code instructions across 3 chapters: G90.81 — Serotonin syndrome, R65.11 — Systemic inflammatory response syndrome (SIRS) of non-infectious origin with acute organ dysfunction, R65.2 — Severe sepsis, U07.1 — COVID-19.

These codes instruct coders to additionally report this code when it applies.

MS-DRG Grouper Relationships (FY2027)

Potential MS-DRG participation — not a DRG assignment.

FY2027 MS-DRG: MCC — Major Complication or Comorbidity. Reported as a secondary diagnosis, this code raises the stay's MS-DRG severity tier — except when the principal diagnosis is one of 51 clinically related codes on its CMS exclusion list.

Named in the grouper logic of 3 MS-DRGs: DRG 791 (MDC 15), DRG 793 (MDC 15), DRG 813 (MDC 16).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Clinical classification (AHRQ CCSR):BLD006 — Coagulation and hemorrhagic disorders (default).

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Related Codes

Same clinical process (MS-DRG)

Acts as MCC — raises the severity of other admissions. CMS groups these diagnoses into one MS-DRG principal-diagnosis exclusion process — a CC/MCC on this list never raises severity when the principal diagnosis is also on it.

D47.4 — Osteomyelofibrosis, D66 — Hereditary factor VIII deficiency, D67 — Hereditary factor IX deficiency, D68.00 — Von Willebrand disease, unspecified, D68.01 — Von Willebrand disease, type 1, D68.020 — Von Willebrand disease, type 2A, D68.021 — Von Willebrand disease, type 2B, D68.022 — Von Willebrand disease, type 2M, D68.023 — Von Willebrand disease, type 2N, D68.029 — Von Willebrand disease, type 2, unspecified, D68.03 — Von Willebrand disease, type 3, D68.04 — Acquired von Willebrand disease, D68.09 — Other von Willebrand disease, D68.1 — Hereditary factor XI deficiency, D68.2 — Hereditary deficiency of other clotting factors, D68.311 — Acquired hemophilia, D68.312 — Antiphospholipid antibody with hemorrhagic disorder, D68.318 — Other hemorrhagic disorder due to intrinsic circulating anticoagulants, antibodies, or inhibitors, D68.32 — Hemorrhagic disorder due to extrinsic circulating anticoagulants, D68.4 — Acquired coagulation factor deficiency, +30 more

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Coagulation and hemorrhagic disorders).

D47.3 — Essential (hemorrhagic) thrombocythemia, D66 — Hereditary factor VIII deficiency, D67 — Hereditary factor IX deficiency, D68.0 — Von Willebrand disease, D68.00 — Von Willebrand disease, unspecified, D68.01 — Von Willebrand disease, type 1, D68.020 — Von Willebrand disease, type 2A, D68.021 — Von Willebrand disease, type 2B, D68.022 — Von Willebrand disease, type 2M, D68.023 — Von Willebrand disease, type 2N, D68.029 — Von Willebrand disease, type 2, unspecified, D68.03 — Von Willebrand disease, type 3, D68.04 — Acquired von Willebrand disease, D68.09 — Other von Willebrand disease, D68.1 — Hereditary factor XI deficiency, D68.2 — Hereditary deficiency of other clotting factors, D68.311 — Acquired hemophilia, D68.312 — Antiphospholipid antibody with hemorrhagic disorder, D68.318 — Other hemorrhagic disorder due to intrinsic circulating anticoagulants, antibodies, or inhibitors, D68.32 — Hemorrhagic disorder due to extrinsic circulating anticoagulants, +31 more

Same Index main term, other category

The ICD-10-CM Index to Diseases and Injuries files this code under the main terms “Deficiency, deficient”, “Absence”, “Afibrinogenemia”, …; these codes share that main term but sit in a different category of the Tabular List.

B65.9 — Schistosomiasis, unspecified (in, bilharziasis), B78.9 — Strongyloidiasis, unspecified (in, strongyloidiasis), C88.0 — Waldenström macroglobulinemia (in, Waldenström macroglobulinemia), C90.0 — Multiple myeloma (in, multiple myeloma), D50.9 — Iron deficiency anemia, unspecified (iron, anemia), D51.0 — Vitamin B12 deficiency anemia due to intrinsic factor deficiency (intrinsic, factor), D51.2 — Transcobalamin II deficiency (transcobalamine II), D53.0 — Protein deficiency anemia (protein, anemia), D55.0 — Anemia due to glucose-6-phosphate dehydrogenase [G6PD] deficiency (glucose-6-phosphate dehydrogenase, anemia), D64.9 — Anemia, unspecified (hemoglobin), D66 — Hereditary factor VIII deficiency (factor, VIII), D67 — Hereditary factor IX deficiency (PTC), D68.01 — Von Willebrand disease, type 1 (von Willebrand factor, partial quantitative), D68.03 — Von Willebrand disease, type 3 (von Willebrand factor, complete), D68.1 — Hereditary factor XI deficiency (PTA), D68.2 — Hereditary deficiency of other clotting factors (fibrinogen), D68.4 — Acquired coagulation factor deficiency (AC globulin, acquired), D68.59 — Other primary thrombophilia (protein, S), D68.8 — Other specified coagulation defects, D68.9 — Coagulation defect, unspecified (clotting), +420 more

Lab tests where this diagnosis supports Medicare coverage (NCD)

Medicare's National Coverage Determination (NCD) program lists this diagnosis as medical justification for these lab tests.

Fecal Occult Blood Test (FOBT), Gamma-glutamyl Transferase (GGT) Test, Iron Panel, Partial Thromboplastin Time (PTT) Test, Prothrombin Time Test and INR (PT/INR)

Contextual Map

Every relationship of D65 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Run D65 with these 24 related codes in Claim Check

Hierarchy

Excludes1

Excludes2

Referenced by Excludes1 notes

Referenced by Excludes2 notes (10)

Referenced by Code First instructions (22)

Referenced by Use Additional Code instructions

Clinical classification (CCSR)

MS-DRG Grouper

  • MCC — Major Complication or Comorbidity [MS-DRG severity]: “As a secondary diagnosis this code can raise the stay's MS-DRG severity tier (MCC).”— CMS MS-DRG Definitions Manual (Appendix C) · FY2027
  • DRG 791 — PREMATURITY WITH MAJOR PROBLEMS[MS-DRG]: “PREMATURITY WITH MAJOR PROBLEMS (MDC 15)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2027
  • DRG 793 — FULL TERM NEONATE WITH MAJOR PROBLEMS[MS-DRG]: “FULL TERM NEONATE WITH MAJOR PROBLEMS (MDC 15)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2027
  • DRG 813 — COAGULATION DISORDERS[MS-DRG]: “COAGULATION DISORDERS (MDC 16)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2027

MDC crossing

Index entries (20)

  • Absence (of) (organ or part) (complete or partial), fibrinogen (congenital), acquired[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Afibrinogenemia, acquired[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Coagulation, intravascular (diffuse) (disseminated), COVID-19 associated[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Coagulopathy, consumption[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Coagulopathy, intravascular[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Defibrination (syndrome)[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Deficiency, deficient, fibrinogen (congenital) (hereditary), acquired[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Disorder (of), glomerular (in), disseminated intravascular coagulation[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • and 12 more

Change history

  • FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016

Sources for this page

Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.

Code, title, tabular notes and index terms Official source data
CMS/CDC ICD-10-CM FY2027 tabular list, index and tables, effective October 1, 2026 Release, file and checksum · Publisher’s page
Coding guidelines Official source data
ICD-10-CM Official Guidelines for Coding and Reporting (FY2027), quoted by section Release, file and checksum · Publisher’s page
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v44.0 (October 2026) Release, file and checksum · Publisher’s page
Inpatient payment groups Official source data
CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v44 Release, file and checksum · Publisher’s page
Change history and date-of-service validity Official source data
CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page
Comparisons, relationships and the contextual map MedCoder structured relationship
Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
Summary and FAQ answers MedCoder explanation
Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.

Labels on this page: Official source data · MedCoder structured relationship · MedCoder explanation. How to read the labels · All data sources and release dates

Cite this page

Reference this page in a research guide, syllabus or article. The release is included because code content changes each year.

MedCoder.ai. "D65 — Disseminated intravascular coagulation [defibrination syndrome]." ICD-10-CM FY2027. https://medcoder.ai/icd10/code/d65-disseminated-intravascular-coagulation-defibrination-syndrome

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Disseminated intravascular coagulation [defibrination syndrome]

No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027, and none are recorded for this code. Note changes are tracked from FY2027 only.