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ICD-10-CM D69.42: Congenital and hereditary thrombocytopenia purpura

D69.42 is the billable ICD-10-CM code for congenital and hereditary thrombocytopenia purpura, in category D69 (Purpura and other hemorrhagic conditions) of the Coagulation defects, purpura and other hemorrhagic conditions section. As a principal diagnosis it groups to MS-DRG 813 Coagulation Disorders (MDC 16 MDC 16: Diseases and Disorders of Blood, Blood Forming Organs and Immunologic Disorders). It maps to HCC 112 (Immune Thrombocytopenia and Specified Coagulation Defects and Hemorrhagic Conditions) in CMS-HCC V28. As a secondary diagnosis it is a CC, excluded with 53 principal diagnoses. 11 LCD billing and coding articles list it as covered.

Compiled from CMS files by the QuickIntell RCM Editorial Team · Data effective · Method: reference methodology · Report a data correction

Data currency: ICD-10-CM code descriptions: FY2027 (effective October 1, 2026); IPPS Table 5 (MS-DRG weights): v44 FY2027 (final rule + CN3) (effective October 1, 2026); ICD-10-CM to HCC mapping: PY2027 initial ICD-10-CM mappings (dates of service 2026) (payment year 2027); Medicare Coverage Database billing and coding articles: MCD release October 8, 2026 (effective October 4, 2026). Next CMS release: FY2028 code files, effective October 1, 2027 for the ICD-10-CM code descriptions; FY2028 final rule (August 2027), effective October 1, 2027; an April 1 interim grouper update when CMS issues one for the IPPS Table 5 (MS-DRG weights); PY2028 advance notice (February 2027) and the PY2027 midyear final mapping (spring 2027) for the ICD-10-CM to HCC mapping; weekly, every Thursday for the Medicare Coverage Database billing and coding articles.

Code
D69.42
billable FY2027 ICD-10-CM code
Category
D69 Purpura and other hemorrhagic conditions
Chapter
3: Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism (D50-D89)
CC/MCC (MS-DRG v44)
CC
CMS-HCC V28
HCC 112
POA reporting
Required

Tabular list notes for D69.42

The tabular list has no notes on D69.42 itself; the notes below apply from its parent headings.

Inherited from D69 (Purpura and other hemorrhagic conditions)

Excludes1 (never coded together)
  • benign hypergammaglobulinemic purpura (D89.0)
  • cryoglobulinemic purpura (D89.1)
  • essential (hemorrhagic) thrombocythemia (D47.3)
  • hemorrhagic thrombocythemia (D47.3)
  • purpura fulminans (D65)
  • thrombotic thrombocytopenic purpura (M31.19)
  • Waldenström hypergammaglobulinemic purpura (D89.0)

Inherited from D69.4 (Other primary thrombocytopenia)

Excludes1 (never coded together)
  • transient neonatal thrombocytopenia (P61.0)
  • Wiskott-Aldrich syndrome (D82.0)

MS-DRG grouping when D69.42 is the principal diagnosis

MS-DRG v44 groups for D69.42 as principal diagnosis
MDCMS-DRGs
16 MDC 16: Diseases and Disorders of Blood, Blood Forming Organs and Immunologic Disorders813

The final group also depends on procedures, secondary diagnoses and discharge status; the MS-DRG lookup for D69.42 shows the full grouping logic.

CC/MCC status and inpatient edits

As a secondary diagnosis, D69.42 is a CC under MS-DRG v44, unless the principal diagnosis is one of the 53 codes in its exclusion list. Check D69.42 against a principal diagnosis.

  • Present on admission: a POA indicator is required on inpatient claims.

CMS-HCC V28 risk adjustment

In the PY2027 mapping, D69.42 maps to HCC 112 (Immune Thrombocytopenia and Specified Coagulation Defects and Hemorrhagic Conditions). The HCC lookup shows the RAF weight and the hierarchy.

LCD billing and coding articles that list D69.42

11 current Medicare billing and coding articles list D69.42 among the diagnoses that support medical necessity for the services they cover.

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Frequently asked questions

What does ICD-10-CM D69.42 mean?

D69.42 means congenital and hereditary thrombocytopenia purpura. It is one of 13 billable codes under D69, purpura and other hemorrhagic conditions.

What can't be coded with D69.42?

Excludes1 at D69.4: transient neonatal thrombocytopenia (P61.0); Wiskott-Aldrich syndrome (D82.0). These are never reported together with D69.42.

Which MS-DRG does D69.42 group to?

As the principal diagnosis, D69.42 groups to MS-DRG 813 Coagulation Disorders (MDC 16 MDC 16: Diseases and Disorders of Blood, Blood Forming Organs and Immunologic Disorders) under MS-DRG v44, before procedures and secondary diagnoses are applied.

Does D69.42 map to an HCC?

Yes: HCC 112, Immune Thrombocytopenia and Specified Coagulation Defects and Hemorrhagic Conditions, in the PY2027 CMS-HCC V28 mapping.

Is D69.42 a CC or MCC?

D69.42 is a CC under MS-DRG v44; 53 principal diagnoses exclude it.

Sources

Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-10. Verify against the primary file before billing or contracting decisions. The reference methodology explains how each figure is computed from these files.

Disclaimer

The descriptor and notes are reproduced from the FY2027 ICD-10-CM files; MS-DRG, CC/MCC and HCC facts come from the CMS FY2027 and PY2027 tables. Code from the medical record and the ICD-10-CM Official Guidelines. Not legal, clinical or billing advice.

Found a figure that does not match the CMS file? Report a data correction with the CMS file and the value you expected; the request reaches the editorial team through the contact form.