Basics of ICD-10 CM codes of Thrombocytopenia

Thrombocytopenia occurs when your bone marrow doesn’t make enough platelets. Platelets form blood clots to help stop bleeding. D69.6 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.

Clinical Information

• A condition in which there is a lower-than-normal number of platelets in the blood. It may result in easy bruising and excessive bleeding from wounds or bleeding in mucous membranes and other tissues.
• A condition in which there is an abnormally small number of platelets in the circulating blood.
• A decrease in the number of platelets in the blood that may result in easy bruising and excessive bleeding from wounds or bleeding in mucous membranes and other tissues.
• A finding based on laboratory test results that indicate a decrease in number of platelets in a blood specimen.
• A subnormal level of blood platelets.
• Decrease in the number of blood platelets.

Documentation and codes

ICD-10-CM coding for thrombocytopenia depends on the disorder’s etiology.

Drug-induced thrombocytopenia

The ICD-10-CM codes for drug-induced thrombocytopenia available are mainly for heparin. The codes are found in category D75.82- (heparin-induced thrombocytopenia [HIT]), but they also include D75.84 (other platelet-activating anti-PF4 disorders), which can be used to report vaccine-induced thrombotic thrombocytopenia.

Gestational thrombocytopenia

Coders can use codes from category O36.82- (fetal anemia and thrombocytopenia) to report thrombocytopenia as it occurs within the fetus. Because these codes pertain to obstetrics, coders should remember to check documentation for specifics on the trimester and multiple births, as that information is needed to code them accurately. Additionally, according to the 2023 ICD-10-CM Guidelines, codes from category O36.- (maternal care for other fetal problems) “are assigned only when the fetal condition is actually responsible for modifying the management of the mother” and are only reported on the mother’s record.

Immune (idiopathic) thrombocytopenic purpura

Immune (idiopathic) thrombocytopenic purpura can be reported with ICD-10-CM code D69.3 (immune thrombocytopenic purpura), as its clarifying terms include “hemorrhagic (thrombocytopenic) purpura,”

“idiopathic thrombocytopenic purpura,” and “tidal platelet dysgenesis.”

Thrombotic thrombocytopenic purpura

ICD-10-CM code D75.84 (other platelet-activating anti-PF4 disorders) can also be used to report thrombotic thrombocytopenic purpura, as one of its clarifying terms is “thrombosis with thrombocytopenia syndrome.”

The ICD-10-CM codes also include various other forms of thrombocytopenia not mentioned above, including congenital or hereditary thrombocytopenia, which is reported with code D69.42 (congenital and hereditary thrombocytopenia purpura), and unspecified thrombocytopenia, which is reported with code D69.6 (thrombocytopenia, unspecified).

Codes in subcategory D75.- (other and unspecified disease of blood and blood-forming organs) have an Excludes2 note of the following codes: 

• acute lymphadenitis (L04.-)
• chronic lymphadenitis (I88.1)
• enlarged lymph nodes (R59.-)
• hypergammaglobulinemia NOS (D89.2)
• lymphadenitis NOS (I88.9)
• mesenteric lymphadenitis (acute) (chronic) (I88.0)

Codes in Chapter 3 (D50-D89) have an Exclude2 note for the following codes: 

• 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)

Excludes1 notes indicate which codes should never be reported together, while Excludes2 notes show which codes can be reported together, given the proper specificity and documentation.