ICD-10 D46.21
Billable / Specific HCC v28: 46Refractory anemia with excess of blasts 1
About ICD-10-CM D46.21
ICD-10-CM code D46.21 represents Refractory anemia with excess of blasts 1. This is a billable/specific code in the Neoplasms chapter (block D46). The 2026 edition of ICD-10-CM D46.21 became effective on October 1, 2025.
Coding Tips for D46.21
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
D46.21 is a CMS-HCC v28 risk-adjustment code (category 46). To count for the patient Risk Adjustment Factor (RAF), document the diagnosis with MEAT language each calendar year: Monitored, Evaluated, Assessed, Treated. A diagnosis on the problem list alone does not satisfy CMS RADV audit standards. Include the diagnosis in the assessment with current status and current treatment plan.
Inclusion Terms / Approximate Synonyms
Clinical terms and conditions classified under D46.21. Per CMS ICD-10-CM Tabular 2026.
- RAEB 1
Medicare Advantage HCC Impact
Capture this diagnosis annually for accurate risk adjustment. Missed HCC captures are the #1 revenue leak in Medicare Advantage risk programs.
Medicare LCD Coverage for D46.21
Local Coverage Determinations (LCDs) from CMS MACs that list D46.21 as a covered diagnosis.
Showing top 10 of 1,207 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing D46.21.
1 Cigna
5 Medicare
CPT Codes Commonly Billed with D46.21
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
- 88291 CMS LCD: Billing and Coding: MDS FISH CMS LCD
- 88275 CMS LCD: Billing and Coding: MDS FISH CMS LCD
- 88273 CMS LCD: Billing and Coding: MDS FISH CMS LCD
- 88274 CMS LCD: Billing and Coding: MDS FISH CMS LCD
- 88271 CMS LCD: Billing and Coding: MDS FISH CMS LCD
- 83018 CMS LCD: Billing and Coding: Heavy Metal Testing CMS LCD
- 82175 CMS LCD: Billing and Coding: Heavy Metal Testing CMS LCD
- 82108 CMS LCD: Billing and Coding: Heavy Metal Testing CMS LCD
- 84630 CMS LCD: Billing and Coding: Heavy Metal Testing CMS LCD
- 83015 CMS LCD: Billing and Coding: Heavy Metal Testing CMS LCD
Convert D46.21 to ICD-9-CM
Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.
| ICD-10 | ICD-9 | Mapping Flags |
|---|---|---|
| D46.21 | 23872 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To D46.21
Other codes in section D37-D48 (Neoplasms of uncertain behavior, polycythemia vera and myelodysplastic syndromes).
ICD-10 D46.21, Billing FAQ
Is ICD-10 code D46.21 billable? +
Yes, D46.21 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
What other names or terms map to D46.21? +
ICD-10 D46.21 includes: RAEB 1.
Does D46.21 affect Medicare Advantage HCC risk adjustment? +
Yes. D46.21 maps to CMS-HCC v28 category 46. Capture this diagnosis annually for accurate Medicare Advantage risk score.
What CPT codes are commonly billed with D46.21? +
Procedures frequently paired with D46.21 include: 88291, 88275, 88273, 88274, 88271.
What ICD-9 codes does D46.21 map to? +
Per CMS GEMs, D46.21 maps to ICD-9 codes: 23872. Useful for legacy data review and historical claim analysis.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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