2026 ICD-10-CM Diagnosis Code D65Disseminated intravascular coagulation [defibrination syndrome]
ICD-10-CM Codes›D50–D89›D65-D69›D65
- Billable — Valid for Submission
- MCC — Major Complication or Comorbidity
- Not Chronic
D65 is a billable ICD-10-CM diagnosis code for disseminated intravascular coagulation [defibrination syndrome]. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) 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 50 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 2026.
Code Identity
Code Classification
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.
Source: CMS Payment Year 2026 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
Tabular List NotesGuidance
Coding notes and annotation back-references applicable to this code.
Inclusion Terms
- 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
Code Also
- , if applicable, associated condition
Type 1 Excludes
- disseminated intravascular coagulation (complicating):
- abortion or ectopic or molar pregnancy O00 O07 O08.1
- in newborn P60
- pregnancy, childbirth and the puerperium O45.0 O46.0 O67.0 O72.3
These terms are the conditions for which that code is to be used. The terms may be synonyms of the code title, or, in the case of "other specified" codes, the terms are a list of the various conditions assigned to that code. The inclusion terms are not necessarily exhaustive. Additional terms found only in the Alphabetic Index may also be assigned to a code.
A "code also" note instructs that two codes may be required to fully describe a condition, but this note does not provide sequencing direction.
A type 1 excludes note is a pure excludes note. It means "NOT CODED HERE!" An Excludes1 note indicates that the code excluded should never be used at the same time as the code above the Excludes1 note. An Excludes1 is used when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition.
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
Afibrinogenemia See Also: Defect, coagulation; D68.8
acquired D65
Coagulation, intravascular (diffuse) (disseminated) See Also: Defibrination syndrome;
COVID-19 associated See Also: COVID-19; D65
Coagulopathy See Also: Defect, coagulation;
consumption D65
intravascular D65
Disorder (of) See Also: Disease;
Glomerulonephritis See Also: Nephritis; N05.9
gangrenous D65
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Clinical InformationClinical
Disseminated Intravascular Coagulation
a disorder characterized by procoagulant substances entering the general circulation causing a systemic thrombotic process. the activation of the clotting mechanism may arise from any of a number of disorders. a majority of the patients manifest skin lesions, sometimes leading to purpura fulminans.Purpura Fulminans
a severe, rapidly fatal reaction occurring most commonly in children following an infectious illness. it is characterized by large, rapidly spreading skin hemorrhages, fever, or shock. purpura fulminans often accompanies or is triggered by disseminated intravascular coagulation.Waterhouse-Friderichsen Syndrome
a condition of hemorrhage and necrosis of the adrenal gland. it is characterized by rapidly developing adrenal insufficiency; hypotension; and widespread cutaneous purpura.Afibrinogenemia
a deficiency or absence of fibrinogen in the blood.Fibrinogen
plasma glycoprotein clotted by thrombin, composed of a dimer of three non-identical pairs of polypeptide chains (alpha, beta, gamma) held together by disulfide bonds. fibrinogen clotting is a sol-gel change involving complex molecular arrangements: whereas fibrinogen is cleaved by thrombin to form polypeptides a and b, the proteolytic action of other enzymes yields different fibrinogen degradation products.Afibrinogenemia
a blood coagulation disorder characterized by the complete absence of fibrinogen in the blood, resulting in bleeding.
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.
Code HistoryHistory
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, 2025 through September 30, 2026.
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, 2025 through September 30, 2026.
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 791, 793, 813, with relative weights from 1.5253 to 4.1696 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 2026. 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 50 closely related codes in its exclusion list.
What is the ICD-9 equivalent of D65?
Under the General Equivalence Mappings, disseminated intravascular coagulation [defibrination syndrome] converts to ICD-9-CM 286.6 (defibrination syndrome). The mapping is a direct match.
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).
