2027 ICD-10-CM Diagnosis Code D68.4Acquired coagulation factor deficiency

ICD-10-CM Codes›D50–D89›D65-D69›D68

ICD-10-CM D68.4
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

D68.4 is a billable ICD-10-CM diagnosis code for acquired coagulation factor deficiency. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 813. As a secondary diagnosis, it counts as a complication or comorbidity (CC) and moves an inpatient stay to a higher severity level within 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.

D68.4 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
D68.4
Billable Status
Yes — Valid for Submission
Code Describes
Acquired coagulation factor deficiency
Short Description
Acquired coagulation factor deficiency
Same as the full description in the CMS dataset.
Parent Code
D68
Other coagulation defects

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
CategoryD68Other coagulation defects
This CodeD68.4Acquired coagulation factor deficiency

Medicare Risk Adjustment (HCC)Billing

D68.4 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
D68.4 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.

  • Acquired coagulation factor deficiency
  • Acquired combined coagulation factor deficiency
  • Acquired factor II deficiency
  • Acquired factor IX deficiency disease
  • Acquired factor V deficiency disease
  • Acquired factor VII deficiency disease
  • Acquired factor VIII deficiency disease
  • Acquired factor X deficiency disease
  • Acquired factor XI deficiency disease
  • Acquired factor XII deficiency disease
  • Acquired factor XIII deficiency disease
  • Acquired hemophilia
  • Acquired prekallikrein deficiency
  • Autoimmune factor VIII deficiency
  • Blood coagulation disorder due to liver disease
  • Deficiency of coagulation factor due to liver disease
  • Deficiency of coagulation factor due to vitamin K deficiency
  • Deficiency of coagulation factor due to vitamin K malabsorption in obstructive biliary disease
  • Factor II deficiency
  • Factor V deficiency
  • Factor VII deficiency
  • Factor X deficiency
  • Factor X deficiency due to systemic amyloidosis
  • Factor XI deficiency
  • Factor XII deficiency disease
  • Factor XIII deficiency disease
  • Idiopathic factor VIII deficiency
  • Malignancy-related factor VIII deficiency
  • Prekallikrein deficiency
  • Prothrombin complex deficiency
  • Vitamin K deficiency
  • Vitamin K deficiency coagulation disorder
  • Vitamin K deficiency coagulation disorder due to malabsorption

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to D68.4: its own notes plus those printed at D68 and 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.

  • Deficiency of coagulation factor due to liver disease
  • Deficiency of coagulation factor due to vitamin K deficiency

Excludes1

Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.

On D68.4 itself
  • vitamin K deficiency of newborn (P53)
From D68 Other coagulation defects applies to 25 codes
  • abnormal coagulation profile NOS (R79.1)

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.

From D68 Other coagulation defects applies to 25 codes
  • coagulation defects complicating abortion or ectopic or molar pregnancy (O00-O07, O08.1)
  • coagulation defects complicating pregnancy, childbirth and the puerperium (O45.0, O46.0, O67.0, O72.3)
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)

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

Referenced in Other NotesGuidance

Instructional notes printed at other codes that name D68.4, its category, or a range that includes it.

Excludes1 2

These codes carry an Excludes1 note naming D68.4: they are not reported together with it, unless the two conditions are unrelated.

  • E56.1 Deficiency of vitamin K
    deficiency of coagulation factor due to vitamin K deficiency (D68.4)
  • R79.1 Abnormal coagulation profile
    coagulation defects (D68.-) names D68.-, which includes this code

Excludes2 1

These codes carry an Excludes2 note naming D68.4: 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) names D65-D68, which includes this code

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

Clinical InformationClinical

  • Acquired Coagulation Factor Deficiency

    deficiency of a coagulation factor that is not caused by genetic alterations. causes include vitamin k deficiency, amyloidosis, and severe liver disease.

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 D68.4 to ICD-9-CMHistory

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

ICD-9-CM
286.7 Acq coagul factor defic
Approximate The match is approximate rather than exact.

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 D68.4Overview

What is the ICD-10 code for acquired coagulation factor deficiency?

The ICD-10-CM code for acquired coagulation factor deficiency is D68.4 (sometimes written as D684). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

Is D68.4 (Other coagulation defects) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report acquired coagulation factor deficiency on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

What MS-DRG does D68.4 group to?

When acquired coagulation factor deficiency is the principal diagnosis on an inpatient stay, it groups to MS-DRG 813 (coagulation Disorders), which carries a relative weight of 1.5279. Higher weights mean higher Medicare reimbursement.

Is D68.4 a CC or MCC?

CMS lists D68.4 as a CC (complication or comorbidity) for FY 2027. Reported as a secondary diagnosis, it moves the inpatient stay to a higher-weighted DRG within its severity family. It does not count when the principal diagnosis is one of the 51 closely related codes in its exclusion list.

Can D68.4 be reported with P53?

Not as a rule. The Excludes1 note on D68.4 lists "vitamin K deficiency of newborn (P53)". 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 D68.4 risk-adjust for Medicare Advantage payment?

Not for Medicare Advantage. D68.4 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).