2026 ICD-10-CM Diagnosis Code D47.4Osteomyelofibrosis
ICD-10-CM Codes›C00–D49›D37-D48›D47
- Billable — Valid for Submission
- Risk Adjusts — HCC 19
- Not Chronic
D47.4 is a billable ICD-10-CM diagnosis code for osteomyelofibrosis. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 814 through 816. Coders also document this condition as myelofibrosis. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Neoplasms of unspecified nature or uncertain behavior.
For Medicare Advantage risk adjustment, D47.4 maps to CMS-HCC Category 19 (Myelodysplastic Syndromes, Multiple Myeloma, and Other Cancers) under the V28 model, adding a risk factor of about 1.798 for a community, non-dual, aged beneficiary in payment year 2026.
Code Identity
Code Classification
Medicare Risk Adjustment (HCC)Billing
D47.4 maps to a payment category in the CMS-HCC model used to risk-adjust Medicare Advantage payments. Weights are the published community factors for payment year 2026.
Source: CMS Payment Year 2026 risk adjustment mappings and model software. Weights are relative factors, not dollar amounts; a beneficiary's total RAF also includes demographics and interactions. Browse all CMS-HCC categories.
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Myelofibrosis
- Primary myelofibrosis
Tabular List NotesGuidance
Coding notes and annotation back-references applicable to this code.
Inclusion Terms
- Chronic idiopathic myelofibrosis
- Myelofibrosis (idiopathic) (with myeloid metaplasia)
- Myelosclerosis (megakaryocytic) with myeloid metaplasia
- Secondary myelofibrosis in myeloproliferative disease
Type 1 Excludes
- acute myelofibrosis C94.4
These terms are the conditions for which that code is to be used. The terms may be synonyms of the code title, or, in the case of "other specified" codes, the terms are a list of the various conditions assigned to that code. The inclusion terms are not necessarily exhaustive. Additional terms found only in the Alphabetic Index may also be assigned to a code.
A type 1 excludes note is a pure excludes note. It means "NOT CODED HERE!" An Excludes1 note indicates that the code excluded should never be used at the same time as the code above the Excludes1 note. An Excludes1 is used when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition.
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
with myeloid metaplasia D47.4
idiopathic (chronic) D47.4
with myeloid metaplasia D47.4
megakaryocytic D47.4
with myeloid metaplasia D47.4
Osteomyelofibrosis D47.4
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Clinical InformationClinical
Primary Myelofibrosis
a de novo myeloproliferation arising from an abnormal stem cell. it is characterized by the replacement of bone marrow by fibrous tissue, a process that is mediated by cytokines arising from the abnormal clone.Cytokines
non-antibody proteins secreted by inflammatory leukocytes and some non-leukocytic cells, that act as intercellular mediators. they differ from classical hormones in that they are produced by a number of tissue or cell types rather than by specialized glands. they generally act locally in a paracrine or autocrine rather than endocrine manner.
Patient EducationClinical
Bone Marrow Diseases
Bone marrow is the spongy tissue inside some of your bones, such as your hip and thigh bones. It contains 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.
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert D47.4 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About D47.4Overview
What is the ICD-10 code for osteomyelofibrosis?
The ICD-10-CM code for osteomyelofibrosis is D47.4 (sometimes written as D474). It is billable on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
Is D47.4 a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report osteomyelofibrosis on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
What MS-DRG does D47.4 group to?
When osteomyelofibrosis is the principal diagnosis on an inpatient stay, it groups to MS-DRG 814, 815, 816, with relative weights from 0.6320 to 2.1267 depending on complications. Higher weights mean higher Medicare reimbursement.
What is the ICD-9 equivalent of D47.4?
Under the General Equivalence Mappings, osteomyelofibrosis converts to ICD-9-CM 289.89 (blood diseases NEC). The mapping is approximate, so confirm the match fits the documentation.
What HCC is D47.4?
D47.4 (osteomyelofibrosis) maps to CMS-HCC Category 19 (Myelodysplastic Syndromes, Multiple Myeloma, and Other Cancers), commonly written as HCC 19, in the CMS-HCC V28 model used for Medicare Advantage risk adjustment in payment year 2026. It mapped to HCC 46 under the retired V24 model. It also maps in the PACE (CMS-HCC V22), ESRD (V21), and ESRD (V24) models. In the Part D prescription drug model it maps to RxHCC 16.
Does D47.4 risk-adjust for Medicare Advantage payment?
Yes. When documented and reported on a Medicare Advantage encounter, D47.4 adds a risk adjustment factor of about 1.798 to the beneficiary's RAF score for a community, non-dual, aged enrollee (published V28 weights range from 0.957 to 1.989 depending on the payment segment). A more severe related category (HCC 17 and HCC 18) supersedes it when both are reported. See the full factor table on the HCC 19 category page.
