Is ICD-10-CM code D46 billable?

No, D46 (Myelodysplastic syndromes) is a non-billable ICD-10-CM code. It must be coded to a more specific subcategory before it can be used for reimbursement.

What chapter does ICD-10-CM code D46 belong to?

D46 belongs to Chapter 2 of the ICD-10-CM tabular list: C00–D49 (Neoplasms).

D46Not billable, use a more specific code below

Myelodysplastic syndromes

In Neoplasms of uncertain behavior, polycythemia vera and myelodysplastic syndromes (D37-D48), chapter 2: Neoplasms

11 billable codes under D46: 2 are a CC; all map to HCC 19 (Myelodysplastic Syndromes, Multiple Myeloma, and Other Cancers), HCC 17 (Cancer Metastatic to Lung, Liver, Brain, and Other Organs; Acute Myeloid Leukemia Except Promyelocytic).A CC or MCC (major CC) is a secondary diagnosis that raises the MS-DRG payment. An HCC counts toward a Medicare Advantage patient's risk score.

Instructional notes

Excludes2: not included here, code separately if applicable

drug-induced aplastic anemia (D61.1)

Use additional code: add a second code for this, listed after this one

code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5)

Also applies, from Neoplasms of uncertain behavior, polycythemia vera and myelodysplastic syndromes (D37-D48)

These notes sit on D37-D48 and apply to every code under it, including D46.

Excludes1: not coded here, use a different code

neoplasms of unspecified behavior (D49.-)

Official coding guidelines

From the ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027 (CMS and NCHS). Links open the PDF at the right page.

Rules for coding benign and malignant neoplasms: using the Neoplasm Table, sequencing primary and secondary sites, treatment encounters, complications, and current cancer versus personal history.

Admission/Encounter for treatment of primary site (page 33)
Admission/Encounter for treatment of secondary site (page 33)
Coding and sequencing of complications (page 34)
Primary malignancy previously excised (page 34)
Admissions/Encounters involving antineoplastic chemotherapy, immunotherapy and radiation therapy (page 35)
Admission/encounter to determine extent of malignancy (page 36)
Symptoms, signs, and abnormal findings listed in Chapter 18 associated with neoplasms (page 36)
Admission/encounter for pain control/management (page 36)

Read Section I.C.2 (page 32), 12 more topics

All codes under D46

D46 can't be used on a claim. Pick a billable code below; grey headings group them.

D46 MS-DRGs

As the principal diagnosis, all 11 billable codes under D46 group to MS-DRG 811 or 812 (v44.0). Which one applies depends on procedures performed, secondary diagnoses (CC/MCC), and the patient's age and discharge status.

Other codes that refer to D46

Notes on these codes point to D46.

C94 Excludes1: myelodysplastic syndromes (D46.-)
D61.02 Code Also: myelodysplastic syndrome (D46.-)
D61.81 Excludes2: pancytopenia (due to) (with) myelodysplastic syndromes (D46.-)
D64 Excludes1: refractory anemia (D46.-)
D75.81 Use Additional Code: code, if applicable, for associated therapy-related myelodysplastic syndrome (D46.-)

About the condition

Plain-language background from MedlinePlus (National Library of Medicine), not coding guidance.

Myelodysplastic Syndromes

Your bone marrow is the spongy tissue inside some of your bones, such as your hip and thigh bones. It contains immature cells, called stem cells. The stem cells can develop into the red blood cells that carry oxygen through your body, the white blood cells that fight infections, and the platelets that help with blood clotting. If you have a myelodysplastic syndrome, the stem cells do not mature into healthy blood cells. Many of them die in the bone marrow. This means that you do not have enough healthy cells, which can lead to infection, anemia, or easy bleeding.

Code history

Valid since FY2016, when ICD-10-CM took effect on October 1, 2015. No changes since.