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v1.0.0
ICD-10 Guide
ICD-10 CodesD68.62

D68.62

Billable

Lupus anticoagulant syndrome

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/05/2025

Code Description

ICD-10 D68.62 is a billable code used to indicate a diagnosis of lupus anticoagulant syndrome.

Key Diagnostic Point:

Lupus anticoagulant syndrome (LAS) is an autoimmune disorder characterized by the presence of antiphospholipid antibodies, particularly lupus anticoagulants, which interfere with the normal coagulation process. Patients with LAS are at increased risk for both venous and arterial thrombosis, leading to complications such as deep vein thrombosis, pulmonary embolism, and stroke. The syndrome is often associated with systemic lupus erythematosus (SLE) but can occur independently. Clinically, patients may present with recurrent miscarriages, thrombocytopenia, and various bleeding disorders due to the paradoxical effects of the antibodies on coagulation pathways. Diagnosis typically involves laboratory tests that detect the presence of lupus anticoagulant, along with a history of thrombosis or pregnancy complications. Management focuses on anticoagulation therapy to reduce thrombotic risk, and careful monitoring is essential to balance the risk of bleeding, especially in patients with concurrent bleeding disorders or those on anticoagulant therapy.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Presence of multiple overlapping conditions (e.g., SLE, thrombocytopenia)
  • Need for comprehensive documentation of clinical history and lab results
  • Potential for misdiagnosis with other coagulation disorders
  • Variability in clinical presentation and management strategies

Audit Risk Factors

  • Inadequate documentation of laboratory test results
  • Failure to document the clinical significance of the condition
  • Misclassification of the condition as a primary diagnosis
  • Lack of follow-up documentation regarding treatment efficacy

Specialty Focus

Medical Specialties

Hematology

Documentation Requirements

Detailed lab results, patient history, and treatment plans must be documented.

Common Clinical Scenarios

Management of patients with recurrent thrombosis or bleeding complications.

Billing Considerations

Ensure accurate documentation of anticoagulation therapy and monitoring.

Rheumatology

Documentation Requirements

Comprehensive assessment of autoimmune symptoms and laboratory findings.

Common Clinical Scenarios

Evaluation of patients with SLE and associated thrombotic events.

Billing Considerations

Document the relationship between lupus symptoms and coagulation issues.

Coding Guidelines

Inclusion Criteria

Use D68.62 When
  • According to ICD
  • 10 guidelines, D68
  • 62 should be used when there is a confirmed diagnosis of lupus anticoagulant syndrome, supported by laboratory findings
  • It is essential to document any associated conditions, such as thrombocytopenia or other bleeding disorders, to provide a complete clinical picture

Exclusion Criteria

Do NOT use D68.62 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

85610CPT Code

Prothrombin time (PT)

Clinical Scenario

Used to monitor anticoagulation therapy in patients with LAS.

Documentation Requirements

Document the reason for testing and results.

Specialty Considerations

Hematology specialists should ensure comprehensive lab documentation.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of lupus anticoagulant syndrome, improving the accuracy of data collection and reimbursement processes. It has also facilitated better tracking of patient outcomes and treatment efficacy.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of lupus anticoagulant syndrome, improving the accuracy of data collection and reimbursement processes. It has also facilitated better tracking of patient outcomes and treatment efficacy.

Reimbursement & Billing Impact

reimbursement processes. It has also facilitated better tracking of patient outcomes and treatment efficacy.

Resources

Clinical References

  • •
    American Society of Hematology

Coding & Billing References

  • •
    American Society of Hematology

Frequently Asked Questions

What is the primary treatment for lupus anticoagulant syndrome?

The primary treatment for lupus anticoagulant syndrome is anticoagulation therapy, which may include medications such as warfarin or direct oral anticoagulants, depending on the patient's clinical scenario and risk factors.