ICD-10 D46.Z
Billable / Specific HCC v28: 46Other myelodysplastic syndromes
About ICD-10-CM D46.Z
ICD-10-CM code D46.Z represents Other myelodysplastic syndromes. This is a billable/specific code in the Neoplasms chapter (block D46). The 2026 edition of ICD-10-CM D46.Z became effective on October 1, 2025.
Coding Tips for D46.Z
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
D46.Z 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.
Type 1 Excludes
Pure excludes, these codes can never be coded together with D46.Z. The conditions are mutually exclusive (e.g., congenital vs acquired forms).
- chronic myelomonocytic leukemia (C93.1-)
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.Z
Local Coverage Determinations (LCDs) from CMS MACs that list D46.Z as a covered diagnosis.
Showing top 10 of 1,426 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing D46.Z.
1 Cigna
5 Medicare
CPT Codes Commonly Billed with D46.Z
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
- 0027U CMS LCD: Billing and Coding: MolDX: Non-Next Generation Sequencing Tests for the Diagnosis of BCR-ABL Negative Myeloproliferative Neoplasms CMS LCD
- 81270 CMS LCD: Billing and Coding: MolDX: Non-Next Generation Sequencing Tests for the Diagnosis of BCR-ABL Negative Myeloproliferative Neoplasms CMS LCD
- 81338 CMS LCD: Billing and Coding: MolDX: Non-Next Generation Sequencing Tests for the Diagnosis of BCR-ABL Negative Myeloproliferative Neoplasms CMS LCD
- 81339 CMS LCD: Billing and Coding: MolDX: Non-Next Generation Sequencing Tests for the Diagnosis of BCR-ABL Negative Myeloproliferative Neoplasms CMS LCD
- 81219 CMS LCD: Billing and Coding: MolDX: Non-Next Generation Sequencing Tests for the Diagnosis of BCR-ABL Negative Myeloproliferative Neoplasms CMS LCD
- 81279 CMS LCD: Billing and Coding: MolDX: Non-Next Generation Sequencing Tests for the Diagnosis of BCR-ABL Negative Myeloproliferative Neoplasms CMS LCD
- 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
Convert D46.Z 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.Z | 23875 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To D46.Z
Other codes in section D37-D48 (Neoplasms of uncertain behavior, polycythemia vera and myelodysplastic syndromes).
ICD-10 D46.Z, Billing FAQ
Is ICD-10 code D46.Z billable? +
Yes, D46.Z is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
What codes are Type 1 Excludes for D46.Z? +
Type 1 Excludes (never code together with D46.Z): chronic myelomonocytic leukemia (C93.1-)
Does D46.Z affect Medicare Advantage HCC risk adjustment? +
Yes. D46.Z 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.Z? +
Procedures frequently paired with D46.Z include: 0027U, 81270, 81338, 81339, 81219.
What ICD-9 codes does D46.Z map to? +
Per CMS GEMs, D46.Z maps to ICD-9 codes: 23875. 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 July 16, 2026.
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