2027 ICD-10-CM Diagnosis Code D65Disseminated intravascular coagulation [defibrination syndrome]

ICD-10-CM Codes›D50–D89›D65-D69›D65

ICD-10-CM D65
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

D65 is a billable ICD-10-CM diagnosis code for disseminated intravascular coagulation [defibrination syndrome]. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 791, 793, 813. As a secondary diagnosis, it counts as a major complication or comorbidity (MCC) and places an inpatient stay in the highest severity level of its MS-DRG family. It does not count, however, when the principal diagnosis is one of 51 closely related codes. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Coagulation and hemorrhagic disorders.

D65 no longer risk-adjusts for Medicare Advantage: it mapped to HCC 48 under the retired CMS-HCC V24 model through payment year 2025 but maps to no category in the live V28 model. It still risk-adjusts in the PACE (CMS-HCC V22) category 48, ESRD (V21) category 48, and ESRD (V24) category 48 for payment year 2027.

Code Identity

ICD-10-CM Code
D65
Billable Status
Yes — Valid for Submission
Code Describes
Disseminated intravascular coagulation [defibrination syndrome]
Short Description
Disseminated intravascular coagulation
Chapter
D65-D69
Coagulation defects, purpura and other hemorrhagic conditions

Code Classification

ChapterD50–D89Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism
SectionD65-D69Coagulation defects, purpura and other hemorrhagic conditions
CategoryD65Disseminated intravascular coagulation [defibrination syndrome]
This CodeD65Disseminated intravascular coagulation [defibrination syndrome]

Medicare Risk Adjustment (HCC)Billing

D65 no longer risk-adjusts for Medicare Advantage: it maps to no payment category in the live CMS-HCC V28 model, although it still risk-adjusts in the other CMS models shown below.

CMS-HCC V28 (Medicare Advantage Payment Model)
Not mapped
Dropped in V28 see all codes that no longer risk-adjust
Prior Model (CMS-HCC V24)
HCC 48
V24 retired last contributed to a Medicare Advantage risk score in payment year 2025
Other CMS Models
PACE (CMS-HCC V22): HCC 48 · ESRD (V21): HCC 48 · ESRD (V24): HCC 48
ESRD V21 weights: 0.059 dialysis, 0.173–0.234 functioning graft · ESRD V24 weights: 0.063 dialysis, 0.192–0.358 functioning graft
Part D (RxHCC)
Not mapped
D65 does not risk-adjust in the RxHCC prescription drug model

Source: CMS Payment Year 2027 risk adjustment mappings and model software. Weights are relative factors, not dollar amounts; a beneficiary's total RAF also includes demographics and interactions. Browse all CMS-HCC categories.

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Abnormal fibrinolysis
  • Acquired afibrinogenemia
  • Acquired fibrinogen abnormality
  • Acquired purpura fulminans
  • Afibrinogenemia
  • Consumption coagulopathy caused by snake venom
  • Disseminated intravascular coagulation
  • Drug-induced fibrinolytic disorder
  • Fibrinolytic bleeding syndrome
  • Fibrinolytic disorder caused by tissue plasminogen activator
  • Fibrinolytic disorder caused by urokinase
  • Hyperfibrinolysis
  • Increased fibrinolysis
  • Purpura fulminans
  • Secondary non-thrombocytopenic purpura
  • Systemic fibrinogenolysis

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to D65: its own notes plus those printed at Chapter 3. A note printed at a category, block or chapter applies to every code under it.

Applicable To

Conditions this code is used for: synonyms of the title or, for "other specified" codes, the conditions assigned to it. The list is not exhaustive.

  • 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: the excluded code is never reported together with this one, unless the two conditions are unrelated.

  • disseminated intravascular coagulation (complicating):
  • in newborn (P60)
  • pregnancy, childbirth and the puerperium (O45.0, O46.0, O67.0, O72.3)

Excludes2

Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.

On D65 itself
  • disseminated intravascular coagulation (complicating):
  • abortion or ectopic or molar pregnancy (O00-O07, O08.1)
From Chapter 3 (D50-D89) Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism applies to 324 codes
  • 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)

Code Also

A second code may be needed to fully describe the condition; the note gives no sequencing direction.

  • if applicable, associated condition

Source: CMS ICD-10-CM Tabular List. How to read instructional notes.

Referenced in Other NotesGuidance

Instructional notes printed at other codes that name D65, its category, or a range that includes it.

Excludes1 2

These codes carry an Excludes1 note naming D65: they are not reported together with it, unless the two conditions are unrelated.

  • D68.6 Other thrombophilia
    diffuse or disseminated intravascular coagulation [DIC] (D65)
  • D69 Purpura and other hemorrhagic conditions
    purpura fulminans (D65)

Excludes2 1

These codes carry an Excludes2 note naming D65: its condition is not part of those codes, and both may be reported when the patient has both.

  • Block R70-R79 Abnormal findings on examination of blood, without diagnosis
    coagulation hemorrhagic disorders (D65-D68)

Code First 1

These codes say to code first a condition named in the note, and D65 is one of the conditions named.

  • N08 Glomerular disorders in diseases classified elsewhere
    disseminated intravascular coagulation (D65)

Use Additional Code 4

These codes say to use an additional code from the note, and D65 is one of the codes named.

  • G90.81 Serotonin syndrome
    disseminated intravascular coagulation (D65)
  • R65.11 Systemic inflammatory response syndrome (SIRS) of non-infectious origin with acute organ dysfunction
    disseminated intravascular coagulopathy [DIC] (D65)
  • R65.2 Severe sepsis
    disseminated intravascular coagulopathy [DIC] (D65)
  • U07.1 COVID-19
    disseminated intravascular coagulation (D65)

Index to Diseases and InjuriesGuidance

Alphabetical index entries that point to this code.

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR BLD006
Coagulation and hemorrhagic disorders
Default principal diagnosis: inpatient Yes · outpatient Yes

Patient EducationClinical

Bleeding Disorders

Normally, if you get hurt, your body forms a blood clot to stop the bleeding. For blood to clot, your body needs cells called platelets and proteins known as clotting factors. If you have a bleeding disorder, you either do not have enough platelets or clotting factors or they don't work the way they should.

Read the full article at MedlinePlus

Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.

Convert D65 to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
286.6 Defibrination syndrome
Exact Match The mapping is direct, with no qualifiers.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2026No changes
FY 2027CurrentCurrent code set, no changesEffective October 1, 2026 through September 30, 2027.

Questions About D65Overview

What is the ICD-10 code for disseminated intravascular coagulation [defibrination syndrome]?

The ICD-10-CM code for disseminated intravascular coagulation [defibrination syndrome] is D65. It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

Is D65 a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report disseminated intravascular coagulation [defibrination syndrome] on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

What MS-DRG does D65 group to?

When disseminated intravascular coagulation [defibrination syndrome] is the principal diagnosis on an inpatient stay, it groups to MS-DRG 793, 791, 813, with relative weights from 1.5279 to 4.2192 depending on complications. Higher weights mean higher Medicare reimbursement.

Is D65 a CC or MCC?

CMS lists D65 as an MCC (major complication or comorbidity) for FY 2027. Reported as a secondary diagnosis, it places the inpatient stay in the highest-weighted DRG of its severity family. It does not count when the principal diagnosis is one of the 51 closely related codes in its exclusion list.

Can D65 be reported with P60?

Not as a rule. The Excludes1 note on D65 lists "in newborn (P60)". An Excludes1 note means the excluded code is never reported together with this one; the only exception is when the two conditions are unrelated to each other (Official Guidelines, Section I.A.12.a).

Does D65 risk-adjust for Medicare Advantage payment?

Not for Medicare Advantage. D65 mapped to HCC 48 in the retired CMS-HCC V24 model, which last determined payment in 2025, but it maps to no category in the live V28 model; see all codes that no longer risk-adjust. It still risk-adjusts in the PACE (CMS-HCC V22) category 48 (Coagulation Defects and Other Specified Hematological Disorders), ESRD (V21) category 48 (Coagulation Defects and Other Specified Hematological Disorders), and ESRD (V24) category 48 (Coagulation Defects and Other Specified Hematological Disorders).