ICD-10 Coding for Factor V Leiden Thrombophilia(D68.59, D68.51)
Complete ICD-10-CM coding and documentation guide for Factor V Leiden Thrombophilia. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Factor V Leiden Thrombophilia
D68.5-D68.6Primary Range
Other coagulation defects
This range includes codes for hereditary thrombophilia, including Factor V Leiden.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| D68.59 | Other primary thrombophilia | Use when Factor V Leiden mutation is confirmed without specific mention of APC resistance. |
|
| D68.51 | Activated protein C resistance | Use when documentation specifies resistance to activated protein C. |
|
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 Factor V Leiden thrombophilia
Essential facts and insights about Factor V Leiden Thrombophilia
Primary ICD-10-CM Codes for factor vomiting leiden thrombophilia
Decision Criteria
clinical Criteria
- Genetic testing confirms Factor V Leiden mutation
documentation Criteria
- Documentation does not specify APC resistance
Applicable To
- Hereditary thrombophilia
- Factor V Leiden mutation
Excludes
- Secondary thrombophilia (D68.69)
Clinical Validation Requirements
- Genetic testing confirming Factor V Leiden mutation
- Personal or family history of venous thromboembolism
Code-Specific Risks
- Incorrectly using this code without genetic confirmation
- Using as primary code when active clot is present
Coding Notes
- Ensure genetic testing confirmation is documented.
D68.51 - Activated protein C resistance
Use when documentation specifies resistance to activated protein C.
Applicable To
- Resistance to activated protein C
Excludes
- Other primary thrombophilia (D68.59)
Clinical Validation Requirements
- APC resistance assay showing reduced APC ratio
- Genetic testing confirming Factor V Leiden mutation
Coding Notes
APC resistance must be documented.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Factor V Leiden Thrombophilia to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code D68.59.
Impact
Clinical: May lead to inappropriate treatment decisions., Regulatory: Non-compliance with documentation standards., Financial: Potential claim denials.
Mitigation Strategy
Specify type of thrombophilia in documentation, Include genetic test results
Impact
Reimbursement: Potential claim denial due to lack of supporting documentation., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate patient records and data.
Mitigation Strategy
Ensure genetic testing results are documented before coding.
Impact
Lack of genetic test documentation for D68.59.
Mitigation Strategy
Ensure all genetic tests are documented in the patient's record.
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 Factor V Leiden Thrombophilia, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Factor V Leiden Thrombophilia
Use these documentation templates to ensure complete and accurate documentation for Factor V Leiden Thrombophilia. These templates include all required elements for proper coding and billing.
Hematology Clinic Visit
Specialty: HematologyRequired Elements
- Genetic test results
- Family history of thrombophilia
- APC resistance assay results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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