D69.1 ICD-10-CM Code: Qualitative platelet defects

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for D69.1 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2026Effective: October 1, 2025

Notes without a marker are published on D69.1 itself; “inherited from” names the category or block whose note applies here.

Coder workflow for D69.1

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

Before you code D69.1

1. Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with D69.1. 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 D69.1’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.

   ReviewD59.3, D89.0, D89.1, D47.3, D65, M31.19

Consider D69.1. Then 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 D69.1(8 notes)

  Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with D69.1: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.

  CompareD59.3, D89.0, D89.1, D47.3, D65, M31.19

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

• Excludes2 — not part of D69.1(1 note)

  Coding workflow: The conditions named in this note are not included in D69.1. When the record documents both, both may be reported; the note is a boundary, not a prohibition.

  CompareD68.0

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

Coding decision scenarios

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

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.

Official Coding Guidelines

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

Don’t confuse D69.1 with…

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

The codes most likely to be picked instead of D69.1 — 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.

• D59.3— 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 hemolytic-uremic syndrome moves the case to D59.3; the two are not reported together unless documented as unrelated.

  Full comparison: D69.1 vs D59.3 →

• D89.0— 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 benign hypergammaglobulinemic purpura moves the case to D89.0; the two are not reported together unless documented as unrelated.

  Full comparison: D69.1 vs D89.0 →

• D89.1— 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 cryoglobulinemic purpura moves the case to D89.1; the two are not reported together unless documented as unrelated.

  Full comparison: D69.1 vs D89.1 →

• D47.3— 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 essential (hemorrhagic) thrombocythemia moves the case to D47.3; the two are not reported together unless documented as unrelated.

  Full comparison: D69.1 vs D47.3 →

• D65— 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 purpura fulminans moves the case to D65; the two are not reported together unless documented as unrelated.

  Full comparison: D69.1 vs D65 →

• M31.19— 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 thrombotic thrombocytopenic purpura moves the case to M31.19; the two are not reported together unless documented as unrelated.

  Full comparison: D69.1 vs M31.19 →

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.

Verify Before Coding

• No Medicare Code Editor or MS-DRG Definitions Manual restrictions apply to this code.

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 D69.1 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 1 Excludes1 note: R23.3 — Spontaneous ecchymoses (via D69.-).

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 (via D69.-), R70-R79 — Abnormal findings on examination of blood, without diagnosis (R70-R79) (via D69.-), R71 — Abnormality of red blood cells (via D69.-), R73 — Elevated blood glucose level (via D69.-), R74 — Abnormal serum enzyme levels (via D69.-), R75 — Inconclusive laboratory evidence of human immunodeficiency virus [HIV] (via D69.-), R76 — Other abnormal immunological findings in serum (via D69.-), R77 — Other abnormalities of plasma proteins (via D69.-), R78 — Findings of drugs and other substances, not normally found in blood (via D69.-), R79 — Other abnormal findings of blood chemistry (via D69.-).

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

Referenced by 21 Code First instructions: T36 — Poisoning by, adverse effect of and underdosing of systemic antibiotics (via D69.-), T36-T39 — Antibiotics & Anti-infectives (T36-T39) (via D69.-), T36-T50 — Poisoning by, adverse effects of and underdosing of drugs, medicaments and biological substances (T36-T50) (via D69.-), T37 — Poisoning by, adverse effect of and underdosing of other systemic anti-infectives and antiparasitics (via D69.-), T38 — Poisoning by, adverse effect of and underdosing of hormones and their synthetic substitutes and antagonists, not elsewhere classified (via D69.-), T39 — Poisoning by, adverse effect of and underdosing of nonopioid analgesics, antipyretics and antirheumatics (via D69.-), T40 — Poisoning by, adverse effect of and underdosing of narcotics and psychodysleptics [hallucinogens] (via D69.-), T40-T41 — Analgesics & Antipyretics (T40-T41) (via D69.-), T41 — Poisoning by, adverse effect of and underdosing of anesthetics and therapeutic gases (via D69.-), T42 — Poisoning by, adverse effect of and underdosing of antiepileptic, sedative- hypnotic and antiparkinsonism drugs (via D69.-), T42-T43 — Anticonvulsants & Psychotropics (T42-T43) (via D69.-), T43 — Poisoning by, adverse effect of and underdosing of psychotropic drugs, not elsewhere classified (via D69.-), T44 — Poisoning by, adverse effect of and underdosing of drugs primarily affecting the autonomic nervous system (via D69.-), T44-T46 — Cardiovascular & Gastrointestinal (T44-T46) (via D69.-), T45 — Poisoning by, adverse effect of and underdosing of primarily systemic and hematological agents, not elsewhere classified (via D69.-), T46 — Poisoning by, adverse effect of and underdosing of agents primarily affecting the cardiovascular system (via D69.-), T47 — Poisoning by, adverse effect of and underdosing of agents primarily affecting the gastrointestinal system (via D69.-), T47-T50 — Hormones & Systemic Agents (T47-T50) (via D69.-), T48 — Poisoning by, adverse effect of and underdosing of agents primarily acting on smooth and skeletal muscles and the respiratory system (via D69.-), T49 — Poisoning by, adverse effect of and underdosing of topical agents primarily affecting skin and mucous membrane and by ophthalmological, otorhinorlaryngological and dental drugs (via D69.-), +1 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 1 Code Also instruction: D68.09 — Other von Willebrand disease.

These codes suggest coding this condition alongside when both are present.

MS-DRG Grouper Relationships (FY2026)

Potential MS-DRG participation — not a DRG assignment.

FY2026 MS-DRG: not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity for that release.

Named in the grouper logic of 1 MS-DRG: 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 CMS-HCC risk category (V28)

CMS maps these diagnoses to the same Hierarchical Condition Category (Immune Thrombocytopenia and Specified Coagulation Defects and Hemorrhagic Conditions) for risk-adjusted payment.

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, D69.3 — Immune thrombocytopenic purpura, D69.41 — Evans syndrome, D69.42 — Congenital and hereditary thrombocytopenia purpura, D69.49 — Other primary thrombocytopenia, D75.84 — Other platelet-activating anti-PF4 disorders, M31.10 — Thrombotic microangiopathy, unspecified, M31.19 — Other thrombotic microangiopathy

Related risk categories

These categories interact through CMS's HCC hierarchy — one can suppress the other's risk-adjustment weight when both are present on a claim.

Hemophilia, Male

Same clinical category (CCSR)

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

D68.4 — Acquired coagulation factor deficiency, D68.51 — Activated protein C resistance, D68.52 — Prothrombin gene mutation, D68.59 — Other primary thrombophilia, D68.61 — Antiphospholipid syndrome, D68.62 — Lupus anticoagulant syndrome, D68.69 — Other thrombophilia, D68.8 — Other specified coagulation defects, D68.9 — Coagulation defect, unspecified, D69.0 — Allergic purpura, D69.2 — Other nonthrombocytopenic purpura, D69.3 — Immune thrombocytopenic purpura, D69.41 — Evans syndrome, D69.42 — Congenital and hereditary thrombocytopenia purpura, D69.49 — Other primary thrombocytopenia, D69.51 — Posttransfusion purpura, D69.59 — Other secondary thrombocytopenia, D69.6 — Thrombocytopenia, unspecified, D69.8 — Other specified hemorrhagic conditions, D69.9 — Hemorrhagic condition, unspecified, +31 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), Iron Panel, Partial Thromboplastin Time (PTT) Test, Prothrombin Time Test and INR (PT/INR)

Contextual Map

Every relationship of D69.1 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 D69.1 with these 20 related codes in Claim Check

Hierarchy

• D50-D89 — Chapter 3: Diseases of the Blood and Blood-forming Organs and Certain Disorders Involving the Immune Mechanism (D50-D89) (D50-D89)[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• D65-D69 — Coagulation defects, purpura and other hemorrhagic conditions[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026

Excludes1

• D59.3 — Hemolytic-uremic syndrome[Excludes1]: “hemolytic-uremic syndrome (D59.3-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026

Excludes2

• D68.0 — Von Willebrand disease[Excludes2]: “von Willebrand disease (D68.0-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026

Referenced by Excludes1 notes

• R23.3 — Spontaneous ecchymoses[Excludes1](via D69.-): “purpura (D69.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026

Referenced by Excludes2 notes (10)

• R70 — Elevated erythrocyte sedimentation rate and abnormality of plasma viscosity[Excludes2](via D69.-): “abnormalities of platelets and thrombocytes (D69.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• R70-R79 — Abnormal findings on examination of blood, without diagnosis (R70-R79)[Excludes2](via D69.-): “abnormalities of platelets and thrombocytes (D69.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• R71 — Abnormality of red blood cells[Excludes2](via D69.-): “abnormalities of platelets and thrombocytes (D69.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• R73 — Elevated blood glucose level[Excludes2](via D69.-): “abnormalities of platelets and thrombocytes (D69.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• R74 — Abnormal serum enzyme levels[Excludes2](via D69.-): “abnormalities of platelets and thrombocytes (D69.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• R75 — Inconclusive laboratory evidence of human immunodeficiency virus [HIV][Excludes2](via D69.-): “abnormalities of platelets and thrombocytes (D69.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• R76 — Other abnormal immunological findings in serum[Excludes2](via D69.-): “abnormalities of platelets and thrombocytes (D69.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• R77 — Other abnormalities of plasma proteins[Excludes2](via D69.-): “abnormalities of platelets and thrombocytes (D69.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• and 2 more

Referenced by Code First instructions (21)

• T36 — Poisoning by, adverse effect of and underdosing of systemic antibiotics[Code First](via D69.-): “blood disorders (D56-D76)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• T36-T39 — Antibiotics & Anti-infectives (T36-T39)[Code First](via D69.-): “blood disorders (D56-D76)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• T36-T50 — Poisoning by, adverse effects of and underdosing of drugs, medicaments and biological substances (T36-T50)[Code First](via D69.-): “blood disorders (D56-D76)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• T37 — Poisoning by, adverse effect of and underdosing of other systemic anti-infectives and antiparasitics[Code First](via D69.-): “blood disorders (D56-D76)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• T38 — Poisoning by, adverse effect of and underdosing of hormones and their synthetic substitutes and antagonists, not elsewhere classified[Code First](via D69.-): “blood disorders (D56-D76)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• T39 — Poisoning by, adverse effect of and underdosing of nonopioid analgesics, antipyretics and antirheumatics[Code First](via D69.-): “blood disorders (D56-D76)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• T40 — Poisoning by, adverse effect of and underdosing of narcotics and psychodysleptics [hallucinogens][Code First](via D69.-): “blood disorders (D56-D76)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• T40-T41 — Analgesics & Antipyretics (T40-T41)[Code First](via D69.-): “blood disorders (D56-D76)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• and 13 more

Referenced by Code Also instructions

• D68.09 — Other von Willebrand disease[Code Also]: “, if applicable, qualitative platelet defects (D69.1-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026

Clinical classification (CCSR)

• BLD006 — Coagulation and hemorrhagic disorders[CCSR]— AHRQ CCSR for ICD-10-CM Diagnoses (HCUP)

Risk adjustment (CMS-HCC)

• HCC 112 — Immune Thrombocytopenia and Specified Coagulation Defects and Hemorrhagic Conditions [CMS-HCC]— CMS-HCC V28 · 2026

MS-DRG Grouper

• DRG 813 — COAGULATION DISORDERS[MS-DRG]: “COAGULATION DISORDERS (MDC 16)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026

MDC crossing

• MDC 16 — Diseases and Disorders of Blood, Blood Forming Organs and Immunologic Disorders[MDC crossing]: “Diseases and Disorders of Blood, Blood Forming Organs and Immunologic Disorders — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs. 1,614 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2026

Nearest codes (16)

• D69 — Purpura and other hemorrhagic conditions[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• D69.0 — Allergic purpura[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• D69.11 — Glanzmann thrombasthenia[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• D69.19 — Other qualitative platelet defects[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• D69.2 — Other nonthrombocytopenic purpura[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• D69.3 — Immune thrombocytopenic purpura[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• D69.4 — Other primary thrombocytopenia[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• D69.41 — Evans syndrome[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• and 8 more

Change history (7)

• FY2027 — Becomes a non-billable header[Change history]— CMS release files (code change ledger) · icd10cm-fy2027
• and 6 more

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 FY2026 tabular list, index and tables, effective October 1, 2025 Release, file and checksum · Publisher’s page

Coding guidelines Official source data

ICD-10-CM Official Guidelines for Coding and Reporting (FY2026), quoted by section Release, file and checksum · Publisher’s page

Claim edits Official source data

CMS Definitions of Medicare Code Edits — v43.1 (April 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 — v43 Release, file and checksum · Publisher’s page

Risk adjustment Official source data

2026 Mid-Year Final ICD-10 Mappings + Model Software (cms.gov/files/zip/2026-midyear-final-icd-10-mappings.zip, 2026-midyear-final-model-software.zip) — CMS-HCC V28, PY2026 mid-year final release 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

Nearest Codes in This Family

Official ICD-10-CM classifications closest to D69.1 in its code family, with their registry titles.

• D69 — Purpura and other hemorrhagic conditions
• D69.0 — Allergic purpura
• D69.11 — Glanzmann thrombasthenia
• D69.19 — Other qualitative platelet defects
• D69.2 — Other nonthrombocytopenic purpura
• D69.3 — Immune thrombocytopenic purpura
• D69.4 — Other primary thrombocytopenia
• D69.41 — Evans syndrome
• D69.42 — Congenital and hereditary thrombocytopenia purpura
• D69.49 — Other primary thrombocytopenia

View all codes in the D69 family