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ICD-10 Coding for Hemophilia(D66, D67)

Complete ICD-10-CM coding and documentation guide for Hemophilia. Includes clinical validation requirements, documentation requirements, and coding pitfalls.

Also known as:

Hereditary Factor VIII DeficiencyHereditary Factor IX DeficiencyBleeding Disorder

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Related ICD-10 Code Ranges

Complete code families applicable to Hemophilia

D66-D68Primary Range

Coagulation Defects

This range includes codes for hereditary and acquired coagulation disorders, including hemophilia A and B.

Code Comparison: When to Use Each Code

Compare key differences between these codes to ensure accurate selection

CodeDescriptionWhen to UseKey Documentation
D66Hereditary factor VIII deficiencyUse for patients with confirmed hereditary factor VIII deficiency.
  • Factor VIII activity <40%
  • Family history or genetic testing confirming hereditary status
D67Hereditary factor IX deficiencyUse for patients with confirmed hereditary factor IX deficiency.
  • Factor IX activity <40%
  • Absence of acquired inhibitors

Clinical Decision Support

Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.

Key Information: ICD-10 code for hemophilia A

Essential facts and insights about Hemophilia

The ICD-10 code for hemophilia A is D66, representing hereditary factor VIII deficiency.

Primary ICD-10-CM Codes for hemophilia

D66
Hereditary factor VIII deficiency
Billable Code

Decision Criteria

clinical Criteria

  • Factor VIII activity <40% confirmed by lab tests

documentation Criteria

  • Family history or genetic testing confirming hereditary status

Applicable To

  • Hemophilia A

Excludes

Clinical Validation Requirements

  • Factor VIII activity <40%
  • Family history or genetic testing confirming hereditary status

Code-Specific Risks

  • Misclassification if documentation does not specify hereditary nature

Coding Notes

  • Ensure documentation specifies hereditary status and includes lab results.
View Full Code Details

Ancillary Codes

Additional codes that should be used in conjunction with the main diagnosis codes when applicable.

Symptomatic hemophilia A carrier status

Z14.02
Use when documenting symptomatic carrier status in females.

Differential Codes

Alternative codes to consider when ruling out similar conditions to the primary diagnosis.

Acquired hemophilia

D68.311
Presence of factor VIII inhibitors and absence of hereditary confirmation

Documentation & Coding Risks

Avoid these common documentation and coding issues when documenting Hemophilia to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code D66.

Impact

Clinical: May lead to inappropriate treatment decisions., Regulatory: Fails to meet coding specificity requirements., Financial: Potential claim denials due to lack of specificity.

Mitigation Strategy

Always specify the type of hemophilia and hereditary status.

Impact

Reimbursement: Incorrect coding may lead to claim denials., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate patient records and data reporting.

Mitigation Strategy

Use D68.311 for acquired hemophilia and document inhibitor titer.

Impact

Using hereditary codes for acquired hemophilia.

Mitigation Strategy

Verify lab results and family history before coding.

Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.

Frequently Asked Questions

Common questions about ICD-10 coding for Hemophilia, with expert answers to help guide accurate code selection and documentation.

Documentation Templates for Hemophilia

Use these documentation templates to ensure complete and accurate documentation for Hemophilia. These templates include all required elements for proper coding and billing.

Severe hemophilia A management

Specialty: Hematology

Required Elements

  • Factor VIII activity
  • Bleeding history
  • Current treatment

Example Documentation

Assessment: Severe hemophilia A (D66) with factor VIII activity 0.5%. Current prophylaxis: Emicizumab 3 mg/kg weekly.

Examples: Poor vs. Good Documentation

Poor Documentation Example
Patient has hemophilia.
Good Documentation Example
Patient has hereditary factor VIII deficiency confirmed by lab tests.
Explanation
The good example specifies the type and hereditary nature, supporting accurate coding.

Need help with ICD-10 coding for Hemophilia? Ask your questions below.

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