D68.4: Acquired coagulation factor deficiency
D68.4, acquired coagulation factor deficiency, is listed as a covered diagnosis in 4 Medicare billing and coding articles that apply to 9 HCPCS Level II codes, including J9312 (Injection, rituximab, 10 mg), Q5123 (Injection, rituximab-arrx, biosimilar, (riabni), 10 mg), Q5119 (Injection, rituximab-pvvr, biosimilar, (ruxience), 10 mg). The articles come from 4 Medicare contractors. A listed diagnosis supports medical necessity only; coverage still depends on the LCD's criteria and on documentation in the medical record.
HCPCS Level II codes with D68.4 as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| J9312 | Injection, rituximab, 10 mg | Special coverage instructions apply | — | 3 |
| Q5123 | Injection, rituximab-arrx, biosimilar, (riabni), 10 mg | Carrier judgment | — | 3 |
| Q5119 | Injection, rituximab-pvvr, biosimilar, (ruxience), 10 mg | Carrier judgment | — | 3 |
| Q5115 | Injection, rituximab-abbs, biosimilar, (truxima), 10 mg | Special coverage instructions apply | — | 3 |
| J9260 | Injection, methotrexate sodium, 50 mg | Special coverage instructions apply | — | 1 |
| J9215 | Injection, interferon, alfa-n3, (human leukocyte derived), 250,000 iu | Special coverage instructions apply | — | 1 |
| G0127 | Trimming of dystrophic nails, any number | Special coverage instructions apply | — | 1 |
| J9311 | Injection, rituximab 10 mg and hyaluronidase | Special coverage instructions apply | — | 1 |
| J3590 | Unclassified biologics | Carrier judgment | — | 1 |
Medicare policy articles listing D68.4
- A55639: Billing and Coding: Chemotherapy Agents for Non-Oncologic Conditions (WPS Insurance Corporation (MAC - Part A, MAC - Part B); 6 Level II codes)
- A57954: Billing and Coding: Routine Foot Care (Noridian Healthcare Solutions, LLC (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L33941, L35138, L37643
- A56380: Billing and Coding: Rituximab (Palmetto GBA (MAC - Part A, MAC - Part B); 6 Level II codes). LCD with the same title: L35026
- A59101: Billing and Coding: Off-label Use of Rituximab and Rituximab Biosimilars (Wellpoint Federal (MAC - Part A, MAC - Part B); 4 Level II codes). LCD with the same title: L38920, L39297
A diagnosis listed as covered in a billing and coding article supports medical necessity for the article's codes; it does not guarantee payment. Coverage depends on the LCD's criteria, the contractor's jurisdiction and documentation in the medical record.
Other D68 diagnoses (Other coagulation defects)
- D68.01 — Von Willebrand disease, type 1
- D68.020 — Von Willebrand disease, type 2A
- D68.021 — Von Willebrand disease, type 2B
- D68.022 — Von Willebrand disease, type 2M
- D68.023 — Von Willebrand disease, type 2N
- D68.03 — Von Willebrand disease, type 3
- D68.04 — Acquired von Willebrand disease
- D68.09 — Other von Willebrand disease
- D68.311 — Acquired hemophilia
- D68.32 — Hemorrhagic disorder due to extrinsic circulating anticoagulants
Frequently asked questions
Does Medicare cover D68.4 (Acquired coagulation factor deficiency)?
Medicare covers items and services, not diagnoses. 4 Medicare billing and coding articles list D68.4 as a covered diagnosis for 9 HCPCS Level II codes: the diagnosis can support medical necessity for those codes, but payment still depends on the LCD's coverage criteria and the medical record.
Which HCPCS codes can be billed with ICD-10 D68.4?
The Level II codes from the policies most specific to this diagnosis are J9312 (Injection, rituximab, 10 mg, 3 articles); Q5123 (Injection, rituximab-arrx, biosimilar, (riabni), 10 mg, 3 articles); Q5119 (Injection, rituximab-pvvr, biosimilar, (ruxience), 10 mg, 3 articles); Q5115 (Injection, rituximab-abbs, biosimilar, (truxima), 10 mg, 3 articles); J9260 (Injection, methotrexate sodium, 50 mg, 1 article). Code choice depends on the item supplied; check each code's descriptor.
Which Medicare policy articles list D68.4?
A55639 (Billing and Coding: Chemotherapy Agents for Non-Oncologic Conditions); A57954 (Billing and Coding: Routine Foot Care); A56380 (Billing and Coding: Rituximab), and 1 more article.
What is ICD-10-CM code D68.4?
D68.4 is the ICD-10-CM code for acquired coagulation factor deficiency, in category D68 (Other coagulation defects), chapter 3: Diseases of the blood and immune mechanism.
Next steps
- Run a reimbursement report for a device billed under J9312
- Watch J9312 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J9312
Sources: CMS Medicare Coverage Database billing and coding articles (covered ICD-10 code lists and HCPCS links); ICD-10-CM FY2026; CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule 2026 (non-rural state fees). Not billing or legal advice.
Chapter 3: Diseases of the blood and immune mechanism · All diagnoses · HCPCS lookup