2026 ICD-10-CM Diagnosis Code D67Hereditary factor IX deficiency

ICD-10-CM Codes›D50–D89›D65-D69›D67

ICD-10-CM D67
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

D67 is a billable ICD-10-CM diagnosis code for hereditary factor IX deficiency. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 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.

For Medicare Advantage risk adjustment, D67 maps to CMS-HCC Category 111 (Hemophilia, Male) under the V28 model, adding a risk factor of about 4.639 for a community, non-dual, aged beneficiary in payment year 2026.

Code Identity

ICD-10-CM Code
D67
Billable Status
Yes — Valid for Submission
Code Describes
Hereditary factor IX deficiency
Short Description
Hereditary factor IX deficiency
Same as the full description in the CMS dataset.
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
CategoryD67Hereditary factor IX deficiency
This CodeD67Hereditary factor IX deficiency

Medicare Risk Adjustment (HCC)Billing

D67 maps to a payment category in the CMS-HCC model used to risk-adjust Medicare Advantage payments. Weights are the published community factors for payment year 2026.

CMS-HCC V28 Category (Payment Model)
HCC 111— Hemophilia, Male
Payment HCC · PY 2026 one of 2 ICD-10-CM codes in this category
Risk Adjustment Factor (RAF) Weight
+4.639
community, non-dual, aged · ranges 4.639–32.199 across segments
Hierarchy
Supersedes HCC 112
less severe related categories are not paid alongside HCC 111
Prior Model (CMS-HCC V24)
HCC 46
V24 retired V28 pays 100% of MA risk scores since PY 2026
Other CMS Models
PACE (CMS-HCC V22): HCC 46 · ESRD (V21): HCC 46 · ESRD (V24): HCC 46
ESRD V21 weights: 0.180 dialysis, 0.766–1.325 functioning graft · ESRD V24 weights: 0.223 dialysis, 0.748–4.064 functioning graft
Part D (RxHCC)
Not mapped
D67 does not risk-adjust in the RxHCC prescription drug model

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.

  • Congenital factor IX deficiency variant
  • Congenital factor IX deficiency with inhibitor
  • Congenital factor IX deficiency without inhibitor
  • Factor IX deficiency
  • Hemophilia B Leyden
  • Hereditary factor IX deficiency disease
  • Hereditary factor IX deficiency disease with inhibitor
  • Hereditary factor IX deficiency disease without inhibitor
  • Mild hereditary factor IX deficiency disease
  • Mild hereditary factor IX deficiency disease with high response inhibitor
  • Mild hereditary factor IX deficiency disease with inhibitor
  • Mild hereditary factor IX deficiency disease with low response inhibitor
  • Mild hereditary factor IX deficiency disease without inhibitor
  • Moderate hereditary factor IX deficiency disease
  • Moderate hereditary factor IX deficiency disease with high response inhibitor
  • Moderate hereditary factor IX deficiency disease with inhibitor
  • Moderate hereditary factor IX deficiency disease with low response inhibitor
  • Moderate hereditary factor IX deficiency disease without inhibitor
  • Severe hereditary factor IX deficiency disease
  • Severe hereditary factor IX deficiency disease with high response inhibitor
  • Severe hereditary factor IX deficiency disease with inhibitor
  • Severe hereditary factor IX deficiency disease with low response inhibitor
  • Severe hereditary factor IX deficiency disease without inhibitor

Tabular List NotesGuidance

Coding notes and annotation back-references applicable to this code.

Inclusion Terms

  • Christmas disease
  • Factor IX deficiency (with functional defect)
  • Hemophilia B
  • Plasma thromboplastin component [PTC] deficiency

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

Hemophilia

Hemophilia is a rare bleeding disorder in which the blood does not clot properly. This can lead to problems with bleeding too much after an injury or surgery. You can also have sudden bleeding inside your body, such as in your joints, muscles, and organs.

The full article covers:

  • What is hemophilia?
  • What are the types of hemophilia?
  • What causes hemophilia?
  • Who is at risk for hemophilia?
  • What are the symptoms of hemophilia?
  • How is hemophilia diagnosed?
  • What are the treatments for hemophilia?

Read the full article at MedlinePlus

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

Convert D67 to ICD-9-CMHistory

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

ICD-9-CM
286.1 Cong factor IX disorder
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 2017–2025No changes
FY 2026CurrentCurrent code set, no changesEffective October 1, 2025 through September 30, 2026.

Questions About D67Overview

What is the ICD-10 code for hereditary factor IX deficiency?

The ICD-10-CM code for hereditary factor IX deficiency is D67. It is billable on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

Is D67 (Hereditary factor IX deficiency) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report hereditary factor IX deficiency on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

What MS-DRG does D67 group to?

When hereditary factor IX deficiency is the principal diagnosis on an inpatient stay, it groups to MS-DRG 813 (coagulation Disorders), which carries a relative weight of 1.5253. Higher weights mean higher Medicare reimbursement.

Is D67 a CC or MCC?

CMS lists D67 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 D67?

Under the General Equivalence Mappings, hereditary factor IX deficiency converts to ICD-9-CM 286.1 (cong factor IX disorder). The mapping is a direct match.

What HCC is D67?

D67 (hereditary factor IX deficiency) maps to CMS-HCC Category 111 (Hemophilia, Male), commonly written as HCC 111, in the CMS-HCC V28 model used for Medicare Advantage risk adjustment in payment year 2026. It mapped to HCC 46 under the retired V24 model. It also maps in the PACE (CMS-HCC V22), ESRD (V21), and ESRD (V24) models. It does not map to any RxHCC in the Part D prescription drug model.

Does D67 risk-adjust for Medicare Advantage payment?

Yes. When documented and reported on a Medicare Advantage encounter, D67 adds a risk adjustment factor of about 4.639 to the beneficiary's RAF score for a community, non-dual, aged enrollee (published V28 weights range from 4.639 to 32.199 depending on the payment segment). HCC 111 sits at the top of its hierarchy, so no other condition category supersedes it. See the full factor table on the HCC 111 category page.