D47.1
BillableChronic myeloproliferative disease
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is D47.1 an HCC code?
Yes. D47.1 maps to Breast, Prostate, Colorectal and Other Cancers and Tumors under the CMS-HCC V28 risk adjustment model (and Coagulation Defects and Other Specified Hematological Disorders under V24).
HCC Category Mapping
RAF weights shown are the community, non-dual, aged base weights from the CMS risk adjustment model file. Actual per-patient RAF contribution depends on member segment, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains in use during the transition and for historical data.
MEAT Criteria for D47.1
For D47.1 to count as a valid HCC diagnosis in a given encounter, the provider's documentation must show MEAT: Monitor, Evaluate, Assess, or Treat. A diagnosis from a prior year does not carry forward automatically — it has to be re-documented and supported each calendar year.
- MMonitor: signs, symptoms, disease progression, or lab trending documented in the note
- EEvaluate: test results, medication response, or physical findings reviewed by the provider
- AAssess: explicit mention in the assessment or plan with acknowledgment of status
- TTreat: medication, referral, procedure, therapy, or counseling tied to the diagnosis
Only one of M/E/A/T is required to support the code, but the documentation must be specific enough to show that the provider actually addressed D47.1 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
D47.1 is the ICD-10-CM diagnosis code for chronic myeloproliferative disease. A group of blood disorders where the bone marrow produces too many blood cells over a long period of time, leading to thickened blood and potential clotting problems. This is a chronic condition that requires ongoing monitoring and management. D47.1 sits in the ICD-10-CM chapter for neoplasms (c00-d49), within the section covering neoplasms of uncertain behavior, polycythemia vera and myelodysplastic syndromes (d37-d48).
Under the CMS-HCC V28 risk adjustment model, D47.1 maps to Breast, Prostate, Colorectal and Other Cancers and Tumors (HCC 21) with a community, non-dual, aged base RAF weight of 0.545. Under the older CMS-HCC V24 model, D47.1 maps to Coagulation Defects and Other Specified Hematological Disorders (HCC 48) with a community, non-dual, aged base RAF weight of 0.209. V28 is the CMS-HCC risk adjustment model that reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition.
Verify the specific type of myeloproliferative disease (polycythemia vera, essential thrombocythemia, primary myelofibrosis) as these may have more specific codes available under D47.1x. Because D47.1 maps to a payment HCC, the provider's documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's Medicare Advantage risk adjustment score. When documentation is ambiguous, coders should issue a provider query rather than assume the highest-specificity variant.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for D47.1 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Verify the specific type of myeloproliferative disease (polycythemia vera, essential thrombocythemia, primary myelofibrosis) as these may have more specific codes available under D47.1x
- •Ensure documentation supports the chronic nature of the condition and distinguish from acute leukemias or other neoplastic disorders that would require different coding
Clinical Significance
Chronic myeloproliferative disease encompasses a group of clonal bone marrow disorders characterized by overproduction of one or more myeloid cell lines. This includes conditions that do not meet specific criteria for polycythemia vera, essential thrombocythemia, or primary myelofibrosis, and these patients face risks of thrombosis, hemorrhage, and disease transformation.
Documentation Requirements
- ✓Documentation should specify the myeloproliferative features including which cell lines are predominantly affected, bone marrow biopsy findings, cytogenetic analysis, and molecular markers (JAK2, CALR, MPL mutations).
- ✓Document peripheral blood counts, spleen size, and any constitutional symptoms.
- ✓Clarify why the condition does not meet criteria for more specific myeloproliferative neoplasm subtypes.