D68.61 — Antiphospholipid syndrome
D68.61 is a billable, specific ICD-10-CM code for antiphospholipid syndrome. It is valid for submission on a claim.
Excludes1 — never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
- anti-phospholipid antibody, finding without diagnosis (R76.0)
Excludes2 — not included here, but may coexist
The excluded condition is not part of this code, but a patient can have both. You may code both.
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Anticardiolipin syndrome
- Antiphospholipid antibody syndrome
Other codes that can never be billed with D68.61
These codes carry an Excludes1 note pointing at D68.61. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading D68.61 alone.
- D68.5Primary thrombophilia
Risk adjustment
D68.61 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.
Medicare coverage
D68.61 is named in 2 Medicare coverage policies — 2 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A56464Billing and Coding: Flow Cytometry
- A57594Billing and Coding: Non-Invasive Peripheral Venous Vascular and Hemodialysis Access Studies
How D68.61 is indexed
Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to D68.61.
- Anticardiolipin syndrome
- Syndrome›anticardiolipin(-antibody)
- Syndrome›antiphospholipid(-antibody)
- Antiphospholipid›antibody›syndrome
- Antibody›anticardiolipin›with›hypercoagulable state
- Antibody›antiphosphatidylglycerol›with›hypercoagulable state
- Antibody›antiphosphatidylinositol›with›hypercoagulable state
- Antibody›antiphosphatidylserine›with›hypercoagulable state
- Antibody›antiphospholipid›with›hypercoagulable state
Related codes at this level
Codes that share D68.6. If D68.61 is not quite right, the correct code is usually one of these.
Questions about D68.61
- Is D68.61 a billable ICD-10-CM code?
- Yes. D68.61 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does D68.61 sit in the tabular list?
- Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism (D50-D89), in the block Coagulation defects, purpura and other hemorrhagic conditions (D65-D69).
- What cannot be coded together with D68.61?
- D68.61 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.