D68.59
Other primary thrombophilia
D68.59 (also written D6859) is a billable ICD-10-CM diagnosis code for other primary thrombophilia. It is part of the FY2027 code set, effective October 1, 2026. It is one of the 25 codes in category D68 (Other coagulation defects). The Alphabetic Index lists it under 11 entries. Its coding notes include 10 Excludes1 entries and 11 Excludes2 entries.
Excludes1
Not coded here. The listed conditions generally should not be reported together.
- antiphospholipid syndrome (D68.61)
- lupus anticoagulant (D68.62)
- secondary activated protein C resistance (D68.69)
- secondary antiphospholipid antibody syndrome (D68.69)
- secondary lupus anticoagulant with hypercoagulable state (D68.69)
- secondary systemic lupus erythematosus [SLE] inhibitor with hypercoagulable state (D68.69)
- systemic lupus erythematosus [SLE] inhibitor finding without diagnosis (R76.0)
- systemic lupus erythematosus [SLE] inhibitor with hemorrhagic disorder (D68.312)
- thrombotic thrombocytopenic purpura (M31.19)
Excludes2
Not included here. Both codes may be reported if the patient has both conditions.
Also from chapter/block level (9 notes)
- 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)
Care settings
How CMS programs treat this code. These are CMS claim edits and list entries, not coverage or eligibility rules.
Home Health Primary
Accepted as the primary (principal) diagnosis on a home health claim. The Home Health Grouper assigns it to the MMTA - Infectious Disease, Neoplasms, and Blood-Forming Diseases clinical group.
Source: CMS Home Health Grouper Software v07.2.26, effective October 1, 2026Hospital CC
Counts as a complication or comorbidity (CC) when reported as a secondary diagnosis on an inpatient claim. It does not count when the principal diagnosis is one of the 42 codes in its exclusion list. Some MS-DRGs also ignore a CC or MCC that defines the DRG.
Source: CMS MS-DRG Definitions Manual v44, effective October 1, 2026, Appendix CInclusion terms
Conditions classified to this code.
- Antithrombin III deficiency
- Hypercoagulable state NOS
- Primary hypercoagulable state NEC
- Primary thrombophilia NEC
- Protein C deficiency
- Protein S deficiency
- Thrombophilia NOS
Alphabetic Index terms
Terms the official Alphabetic Index lists for this code. 11 entries
- Deficiency, deficient, antithrombin (antithrombin III)
- Deficiency, deficient, protein, C
- Deficiency, deficient, protein, S
- Hypercoagulable (state)
- Hypercoagulable (state), antithrombin (III) deficiency
- Hypercoagulable (state), primary NEC
- Hypercoagulable (state), protein C deficiency
- Hypercoagulable (state), protein S deficiency
- Hypercoagulation (state)
- Thrombophilia
- Thrombophilia, primary NEC