C94.6: Myelodysplastic disease, not elsewhere classified
C94.6 is a billable, specific ICD-10-CM code for myelodysplastic disease, not elsewhere classified. It is valid for submission on a claim.
Check C94.6 with the rest of the claim: free scrubberInclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Myelodysplastic/myeloproliferative neoplasm, unclassifiable
- Myeloproliferative disease, not elsewhere classified
Other codes that can never be billed with C94.6
Their own Excludes1 notes name this code, so the conflict is not listed above.
- D72.825Bandemia
Risk adjustment
C94.6 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 19 Myelodysplastic Syndromes, Multiple Myeloma, and Other Cancers1.798 RAF
Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score. Look up the whole chart to see which of its HCCs the hierarchy would zero.
Medicare coverage
C94.6 is named in 44 Medicare coverage policies: 44 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A52480Oral Antiemetic Drugs (Replacement for Intravenous Antiemetics) - Policy Article
- A54768Billing and Coding: Cardiac Blood Pool Imaging (Multiple Gated Acquisition Scanning- MUGA, Ventriculography) When Performed in Conjunction with Cardiotoxic Chemotherapy
- A55717Billing and Coding: Lab: Flow Cytometry
- A56199Billing and Coding: Molecular Pathology Procedures
Alphabetic index entries that lead here
- Disease, diseased›myelodysplastic
- Disease, diseased›myelodysplastic/myeloproliferative neoplasm, unclassifiable
- Neoplasm, neoplastic›myelodysplastic/myeloproliferative, unclassifiable
- Disease, diseased›myeloproliferative›not classified
- Disease, diseased›myeloproliferative›specified NEC
- Disease, diseased›myeloproliferative›unclassifiable
Code history
Unchanged in every release from FY2024 to FY2027.