ICD-10 D47.4
Billable / Specific HCC v28: 46Osteomyelofibrosis
About ICD-10-CM D47.4
ICD-10-CM code D47.4 represents Osteomyelofibrosis. This is a billable/specific code in the Neoplasms chapter (block D47). The 2026 edition of ICD-10-CM D47.4 became effective on October 1, 2025.
Coding Tips for D47.4
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
D47.4 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 D47.4. Per CMS ICD-10-CM Tabular 2026.
- Chronic idiopathic myelofibrosis
- Myelofibrosis (idiopathic) (with myeloid metaplasia)
- Myelosclerosis (megakaryocytic) with myeloid metaplasia
- Secondary myelofibrosis in myeloproliferative disease
Type 1 Excludes
Pure excludes, these codes can never be coded together with D47.4. The conditions are mutually exclusive (e.g., congenital vs acquired forms).
- acute myelofibrosis (C94.4-)
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 D47.4
Local Coverage Determinations (LCDs) from CMS MACs that list D47.4 as a covered diagnosis.
Showing top 10 of 1,094 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing D47.4.
1 Cigna
5 Medicare
CPT Codes Commonly Billed with D47.4
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
Convert D47.4 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 |
|---|---|---|
| D47.4 | 28989 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To D47.4
Other codes in section D37-D48 (Neoplasms of uncertain behavior, polycythemia vera and myelodysplastic syndromes).
ICD-10 D47.4, Billing FAQ
Is ICD-10 code D47.4 billable? +
Yes, D47.4 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 D47.4? +
ICD-10 D47.4 includes: Chronic idiopathic myelofibrosis; Myelofibrosis (idiopathic) (with myeloid metaplasia); Myelosclerosis (megakaryocytic) with myeloid metaplasia, and 1 more clinical synonyms.
What codes are Type 1 Excludes for D47.4? +
Type 1 Excludes (never code together with D47.4): acute myelofibrosis (C94.4-)
Does D47.4 affect Medicare Advantage HCC risk adjustment? +
Yes. D47.4 maps to CMS-HCC v28 category 46. Capture this diagnosis annually for accurate Medicare Advantage risk score.
What CPT codes are commonly billed with D47.4? +
Procedures frequently paired with D47.4 include: 0027U, 81270, 81338, 81339, 81219.
What ICD-9 codes does D47.4 map to? +
Per CMS GEMs, D47.4 maps to ICD-9 codes: 28989. 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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