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v1.0.0
ICD-10 Guide
ICD-10 CodesD69.6

D69.6

Billable

Thrombocytopenia, unspecified

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

Code Description

ICD-10 D69.6 is a billable code used to indicate a diagnosis of thrombocytopenia, unspecified.

Key Diagnostic Point:

Thrombocytopenia is a condition characterized by an abnormally low level of platelets in the blood, which can lead to increased bleeding and bruising. The term 'unspecified' indicates that the underlying cause of the thrombocytopenia has not been determined. This condition can arise from various factors, including bone marrow disorders, autoimmune diseases, infections, and certain medications. In patients with thrombocytopenia, the risk of bleeding can be significant, particularly in cases where platelet counts fall below critical thresholds. Clinicians must evaluate patients for potential bleeding disorders, including hemophilia and other coagulation defects, as these can complicate the management of thrombocytopenia. The diagnosis often requires a thorough clinical history, physical examination, and laboratory tests to assess platelet levels and identify any underlying conditions. Treatment may vary depending on the cause and severity of the thrombocytopenia, ranging from observation to more aggressive interventions such as platelet transfusions or medications that stimulate platelet production.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of potential underlying causes requiring differential diagnosis
  • Need for comprehensive patient history and lab results
  • Potential overlap with other bleeding disorders
  • Variability in clinical presentation and severity

Audit Risk Factors

  • Inadequate documentation of platelet counts
  • Failure to specify underlying causes when known
  • Misclassification with other bleeding disorders
  • Lack of follow-up documentation on treatment outcomes

Specialty Focus

Medical Specialties

Hematology

Documentation Requirements

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

Common Clinical Scenarios

Patients presenting with unexplained bruising, prolonged bleeding after minor injuries, or abnormal lab results.

Billing Considerations

Ensure that all relevant lab tests are included in the documentation to support the diagnosis.

Primary Care

Documentation Requirements

Comprehensive patient history and physical examination findings.

Common Clinical Scenarios

Routine blood tests revealing low platelet counts in asymptomatic patients.

Billing Considerations

Document any referrals to specialists and follow-up care plans.

Coding Guidelines

Inclusion Criteria

Use D69.6 When
  • According to ICD
  • 10 guidelines, D69
  • 6 should be used when the specific cause of thrombocytopenia is not documented
  • Coders should ensure that the diagnosis is supported by clinical findings and lab results

Exclusion Criteria

Do NOT use D69.6 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

85027CPT Code

Complete Blood Count (CBC) with Platelet Count

Clinical Scenario

Used to evaluate patients with suspected thrombocytopenia.

Documentation Requirements

Document the reason for the CBC and any relevant clinical findings.

Specialty Considerations

Hematology specialists may require additional tests based on initial findings.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of thrombocytopenia, improving the ability to capture the nuances of the condition and its causes. D69.6 serves as a catch-all for unspecified cases, but coders must strive for specificity when possible.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of thrombocytopenia, improving the ability to capture the nuances of the condition and its causes. D69.6 serves as a catch-all for unspecified cases, but coders must strive for specificity when possible.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of thrombocytopenia, improving the ability to capture the nuances of the condition and its causes. D69.6 serves as a catch-all for unspecified cases, but coders must strive for specificity when possible.

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

When should I use D69.6?

Use D69.6 when the patient has thrombocytopenia, and the specific cause is not documented. Ensure that clinical findings and lab results support the diagnosis.