D47.4 Osteomyelofibrosis

Billable ICD-10-CM code, FY2026.

Applicable to

• Chronic idiopathic myelofibrosis
• Myelofibrosis (idiopathic) (with myeloid metaplasia)
• Myelosclerosis (megakaryocytic) with myeloid metaplasia
• Secondary myelofibrosis in myeloproliferative disease

Excludes1 (never code together)

• acute myelofibrosis (C94.4-)

Risk adjustment (HCC)

• CMS-HCC V28: HCC 19 — Myelodysplastic Syndromes, Multiple Myeloma, and Other Cancers
• CMS-HCC V22: HCC 46 — Severe Hematological Disorders
• RxHCC V08: HCC 16 — Multiple Myeloma and Other Hematologic Cancers
• ESRD V24: HCC 46

MS-DRG index

Defines the logic of DRG(s) 814-816 in MDC 16.

Approximate ICD-9-CM (GEMs)

• 289.89 Other specified diseases of blood and blood-forming organs (approximate)

Code annotations containing back-references to D47.4

Back-references to D47.4

• Type 1 Excludes: D61.82 Myelophthisis ("myelofibrosis with myeloid metaplasia (D47.4)")
• Type 1 Excludes: D75.81 Myelofibrosis ("myelofibrosis with myeloid metaplasia (D47.4)")

Diagnosis Index entries for D47.4

• Myelofibrosis › with myeloid metaplasia
• Myelofibrosis › idiopathic (chronic)
• Myelofibrosis › secondary › in myeloproliferative disease
• Myelosclerosis › with myeloid metaplasia
• Myelosclerosis › megakaryocytic
• Myelosclerosis › megakaryocytic › with myeloid metaplasia
• Osteomyelofibrosis

Nearby codes

• D47.02 Systemic mastocytosis
• D47.09 Other mast cell neoplasms of uncertain behavior
• D47.1 Chronic myeloproliferative disease
• D47.2 Monoclonal gammopathy
• D47.3 Essential (hemorrhagic) thrombocythemia
• D47.4 Osteomyelofibrosis (this code)
• D47.Z Other specified neoplasms of uncertain behavior of lymphoid, hematopoietic and related tissue
• D47.Z1 Post-transplant lymphoproliferative disorder (PTLD)
• D47.Z2 Castleman disease
• D47.Z9 Other specified neoplasms of uncertain behavior of lymphoid, hematopoietic and related tissue
• D47.9 Neoplasm of uncertain behavior of lymphoid, hematopoietic and related tissue, unspecified