2026 ICD-10-CM Diagnosis Code D68.52Prothrombin gene mutation

ICD-10-CM Codes›D50–D89›D65-D69›D68

ICD-10-CM D68.52
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

D68.52 is a billable ICD-10-CM diagnosis code for prothrombin gene mutation. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 814 through 816. Coders also document this condition as heterozygous prothrombin G20210A mutation. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Coagulation and hemorrhagic disorders.

Code Identity

ICD-10-CM Code
D68.52
Billable Status
Yes — Valid for Submission
Code Describes
Prothrombin gene mutation
Short Description
Prothrombin gene mutation
Same as the full description in the CMS dataset.
Parent Code
D68.5
Primary thrombophilia

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 CodeD68.52Prothrombin gene mutation

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Heterozygous prothrombin G20210A mutation
  • Homozygous prothrombin G20210A mutation
  • Prothrombin G20210A mutation

Index to Diseases and InjuriesGuidance

Alphabetical index entries that point to this code.

External Cause of Injuries IndexGuidance

References for this code in the External Cause of Injuries Index.

    • Hypercoagulable(state)
      • prothrombin gene mutation
    • Mutation(s)
      • prothrombin gene
    • Prothrombin gene mutation

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 D68.52 to ICD-9-CMHistory

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

ICD-9-CM
289.81 Prim hypercoagulable st
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 2017–2025No changes
FY 2026CurrentCurrent code set, no changesEffective October 1, 2025 through September 30, 2026.

Questions About D68.52Overview

Is D68.52 (Primary thrombophilia) a billable code?

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

What MS-DRG does D68.52 group to?

When prothrombin gene mutation is the principal diagnosis on an inpatient stay, it groups to MS-DRG 814, 815, 816, with relative weights from 0.6320 to 2.1267 depending on complications. Higher weights mean higher Medicare reimbursement.

What is the ICD-9 equivalent of D68.52?

Under the General Equivalence Mappings, prothrombin gene mutation converts to ICD-9-CM 289.81 (prim hypercoagulable st). The mapping is approximate, so confirm the match fits the documentation.

Footnotes

[1] Chronic - a chronic condition code indicates a condition lasting 12 months or longer and its effect on the patient based on one or both of the following criteria:

  • The condition results in the need for ongoing intervention with medical products,treatment, services, and special equipment
  • The condition places limitations on self-care, independent living, and social interactions.