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D68.69
ICD-10-CM
Secondary Hypercoagulable State

Understanding Secondary Hypercoagulable State: Find information on diagnosis, clinical documentation, and medical coding for this condition. Explore resources for healthcare professionals, including ICD-10 codes, treatment options, and risk factors associated with acquired thrombophilia. Learn about laboratory testing, differential diagnosis, and best practices for managing secondary hypercoagulable states in clinical settings. This resource offers guidance on proper documentation and coding to ensure accurate billing and reimbursement.

Also known as

Acquired Thrombophilia
Secondary Coagulation Disorder

Diagnosis Snapshot

Key Facts
  • Definition : Acquired condition increasing blood clot risk.
  • Clinical Signs : Deep vein thrombosis, pulmonary embolism, recurrent pregnancy loss.
  • Common Settings : Hospitalized patients, cancer, pregnancy, oral contraceptive use.

Related ICD-10 Code Ranges

Complete code families applicable to AAPC D68.69 Coding
D68.5

Other specified coagulation defects

Covers secondary hypercoagulability not elsewhere classified.

D65-D69

Disorders of coagulation

Includes various coagulation abnormalities, some causing hypercoagulability.

I82

Other venous embolism and thrombosis

Conditions associated with or resulting from hypercoagulable states.

M31.1

Hypercoagulable state with recurrent venous thrombosis

Specific type of hypercoagulability with repeated venous thrombosis.

Code-Specific Guidance

Decision Tree for

Follow this step-by-step guide to choose the correct ICD-10 code.

Is the hypercoagulable state secondary to a known condition?

Code Comparison

Related Codes Comparison

When to use each related code

Description
Secondary Hypercoagulability
Antiphospholipid Syndrome
Factor V Leiden

Documentation Best Practices

Documentation Checklist
  • Document underlying cause (e.g., malignancy, pregnancy)
  • Specify acquired or inherited thrombophilia if known
  • Detail clinical findings (e.g., DVT, PE)
  • Include relevant lab results (e.g., thrombophilia screen)
  • Note treatment plan (e.g., anticoagulation)

Coding and Audit Risks

Common Risks
  • Unspecified Etiology

    Coding D68.59 without documenting the specific cause of the secondary hypercoagulable state leads to inaccurate risk adjustment and potential denials.

  • Missed Underlying Condition

    Failure to code the underlying malignancy or other condition causing the hypercoagulable state impacts severity scores and reimbursement.

  • Confusing Inherited vs Acquired

    Incorrectly coding an acquired hypercoagulable state as inherited (e.g., Factor V Leiden) or vice-versa leads to inaccurate clinical documentation and coding errors.

Mitigation Tips

Best Practices
  • Document acquired risk factors: immobility, malignancy
  • Rule out inherited thrombophilia via genetic testing
  • Specific ICD-10 codes for cause of hypercoagulability
  • Correlate labs (e.g., D-dimer, clotting factors) with clinical findings
  • Ensure CDI aligns documentation with coding guidelines

Clinical Decision Support

Checklist
  • Acquired risk factors documented (malignancy, pregnancy)
  • Medications reviewed (oral contraceptives, HRT)
  • Antiphospholipid antibodies tested (Lupus anticoagulant)
  • Thrombotic event unexplained by primary disorder
  • Appropriate imaging/tests for underlying cause

Reimbursement and Quality Metrics

Impact Summary
  • Secondary Hypercoagulable State: Reimbursement and Quality Metrics Impact Summary
  • Keywords: Medical Billing, Coding Accuracy, ICD-10 D68.8, Hospital Reporting, Coagulation Disorders, Thrombophilia, VTE, Quality Measures
  • Impact 1: Accurate coding (D68.8) maximizes appropriate reimbursement.
  • Impact 2: Misdiagnosis/miscoding can lead to claim denials and lost revenue.
  • Impact 3: Proper documentation impacts VTE prophylaxis quality reporting.
  • Impact 4: Affects hospital acquired conditions (HAC) reporting and penalties.

Streamline Your Medical Coding

Let S10.AI help you select the most accurate ICD-10 codes. Our AI-powered assistant ensures compliance and reduces coding errors.

Quick Tips

Practical Coding Tips
  • Document acquired factor deficiencies
  • Specify underlying cause for coding
  • Query physician for clarity if needed
  • Code primary diagnosis first
  • Review labs for specific deficiencies

Documentation Templates

Patient presents with suspected secondary hypercoagulable state.  Presenting symptoms include [specific symptoms, e.g., recurrent deep vein thrombosis, pulmonary embolism, unexplained thrombotic events, recurrent pregnancy loss].  Patient history is significant for [relevant medical history, e.g., malignancy, recent surgery, trauma, immobilization, inflammatory condition, oral contraceptive use, hormone replacement therapy, pregnancy, antiphospholipid syndrome, nephrotic syndrome, paroxysmal nocturnal hemoglobinuria].  Physical examination reveals [relevant physical findings, e.g., edema, erythema, tenderness along the affected vein, diminished pulses, shortness of breath, chest pain].  Differential diagnosis includes [other possible diagnoses, e.g., inherited thrombophilia, factor V Leiden, prothrombin gene mutation, protein C or S deficiency, antithrombin deficiency].  Diagnostic workup may include [relevant diagnostic tests, e.g., D-dimer, coagulation studies PT, PTT, INR, complete blood count, Doppler ultrasound, CT angiography, VQ scan, thrombophilia screening].  Pre-existing conditions contributing to the hypercoagulable state are [list pre-existing conditions].  Assessment suggests a secondary hypercoagulable state likely secondary to [underlying cause].  Plan of care includes [treatment plan, e.g., anticoagulation therapy with heparin, warfarin, or direct oral anticoagulants DOACs, management of underlying condition, lifestyle modifications including smoking cessation and increased physical activity].  Patient education provided on the importance of medication adherence, follow-up appointments, and signs and symptoms of bleeding and thromboembolic complications.  ICD-10 code [relevant ICD-10 code, e.g., D68.8 Other specified coagulation defects] is considered.  Continued monitoring and reassessment will be necessary to optimize treatment and minimize risk of thrombotic recurrence.