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v1.0.0
ICD-10 Guide
ICD-10 CodesD69.1

D69.1

Billable

Qualitative platelet defects

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

Code Description

ICD-10 D69.1 is a billable code used to indicate a diagnosis of qualitative platelet defects.

Key Diagnostic Point:

Qualitative platelet defects refer to a group of disorders characterized by abnormal platelet function despite normal platelet count. These defects can lead to bleeding tendencies due to impaired hemostasis. Common causes include inherited conditions such as Glanzmann thrombasthenia and Bernard-Soulier syndrome, as well as acquired conditions like uremia or the effects of certain medications. Patients may present with symptoms such as easy bruising, prolonged bleeding from cuts, and excessive bleeding during surgical procedures. Diagnosis typically involves platelet function tests, including aggregometry and platelet adhesion assays, to assess the functional capacity of platelets. Management may include platelet transfusions, desmopressin administration, or treatment of underlying conditions. Understanding the nuances of qualitative defects is crucial for effective management and coding, as these conditions can overlap with other bleeding disorders, necessitating careful documentation and coding practices.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiation from quantitative platelet disorders
  • Overlap with other bleeding disorders like hemophilia
  • Need for specific laboratory test results for accurate coding
  • Potential for misclassification with similar codes

Audit Risk Factors

  • Inadequate documentation of platelet function tests
  • Failure to specify the type of qualitative defect
  • Misuse of related codes leading to upcoding or downcoding
  • Lack of clinical correlation between symptoms and diagnosis

Specialty Focus

Medical Specialties

Hematology

Documentation Requirements

Detailed lab results, patient history, and clinical findings related to bleeding episodes.

Common Clinical Scenarios

Patients presenting with unexplained bleeding, family history of bleeding disorders, or abnormal lab results.

Billing Considerations

Ensure that all relevant tests are documented to support the diagnosis and coding.

Emergency Medicine

Documentation Requirements

Immediate assessment of bleeding, lab results, and treatment provided during the emergency visit.

Common Clinical Scenarios

Patients with acute bleeding episodes requiring urgent intervention.

Billing Considerations

Accurate documentation of the cause of bleeding and any interventions performed is critical.

Coding Guidelines

Inclusion Criteria

Use D69.1 When
  • According to ICD
  • 10 coding guidelines, D69
  • 1 should be used when there is clear documentation of qualitative platelet defects
  • It is important to include specific laboratory findings and clinical symptoms to support the diagnosis

Exclusion Criteria

Do NOT use D69.1 When
  • Exclusion criteria include conditions that do not involve qualitative defects

Related ICD-10 Codes

Related CPT Codes

85049CPT Code

Platelet aggregation studies

Clinical Scenario

Used to evaluate suspected qualitative platelet defects.

Documentation Requirements

Document the indication for the test and results.

Specialty Considerations

Hematology specialists should ensure comprehensive reporting of findings.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of qualitative platelet defects, improving the ability to capture the nuances of these conditions. This specificity aids in better tracking of patient outcomes and resource allocation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of qualitative platelet defects, improving the ability to capture the nuances of these conditions. This specificity aids in better tracking of patient outcomes and resource allocation.

Reimbursement & Billing Impact

reimbursement.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What are qualitative platelet defects?

Qualitative platelet defects are disorders where platelets function abnormally despite normal counts, leading to bleeding issues.

How are qualitative platelet defects diagnosed?

Diagnosis involves clinical evaluation and specialized tests like platelet aggregation studies to assess function.

What is the difference between qualitative and quantitative platelet disorders?

Qualitative disorders involve normal platelet counts with impaired function, while quantitative disorders involve low platelet counts.

What are common symptoms of qualitative platelet defects?

Symptoms include easy bruising, prolonged bleeding from cuts, and excessive bleeding during surgical procedures.