D68.023
Von Willebrand disease, type 2N
Clinical Classification Guidelines
Inclusion Terms
- Qualitative defects of von Willebrand factor with defective von Willebrand factor to factor VIII binding
- Qualitative defects of von Willebrand factor with markedly decreased affinity for factor VIII
Medical Intelligence & Overview
Von Willebrand disease, type 2N, is a hereditary bleeding disorder characterized by a qualitative defect in the von Willebrand factor (VWF). This particular type impacts how effectively VWF binds to factor VIII, a key protein involved in blood clotting. Patients with this condition may experience increased bleeding tendencies due to impaired clot formation. Recognizing the specific nature of type 2N helps in distinguishing it from other subtypes of von Willebrand disease, guiding appropriate diagnosis and management strategies.
Causes & Symptoms
Clinical Causes: Genetic mutation affecting the structure or function of von Willebrand factor, inherited in an autosomal dominant pattern Inheritance from one parent, leading to the production of VWF with defective binding to factor VIII Alterations in the genetic code that result in markedly decreased affinity of VWF for factor VIII
Key Symptoms: Prolonged bleeding from cuts or injuries Frequent bleeding episodes such as nosebleeds (epistaxis) Excessive bruising after minor trauma Heavy or prolonged menstrual bleeding (menorrhagia) Bleeding into joints or muscles in severe cases Unusual bleeding after dental procedures or surgeries Potential spontaneous bleeding without apparent cause
Diagnostic & Treatment
Diagnosis Path: Blood tests to measure levels of von Willebrand factor (VWF) and factor VIII activity VWF multimarker analysis to assess the functional quality of VWF VWF binding assays to evaluate the ability of VWF to bind to platelets and factor VIII Genetic testing to identify specific mutations associated with type 2N Ristocetin cofactor activity test to evaluate VWF function
Treatment Protocols: Desmopressin (DDAVP), which can temporarily increase levels of VWF and factor VIII in some cases Replacement therapy using plasma-derived VWF concentrates containing factor VIII Adjunct therapies such as antifibrinolytics (e.g., tranexamic acid) to reduce bleeding during minor procedures Avoidance of medications that impair platelet function, like aspirin Educating patients about bleeding risks and emergency management practices Regular monitoring of blood clotting parameters and VWF levels
Clinical Advice & FAQs
Billing Guidance
Is D68.023 a billable ICD-10 code?
Yes, D68.023 is a specific, billable code that can be used to indicate a diagnosis for reimbursement purposes.
Documentation
How do I report D68.023?
Clinical documentation must specify the nature of Von Willebrand disease, type 2N and any associated comorbidities for accurate reporting.
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