D47.Z9
BillableOther specified neoplasms of uncertain behavior of lymphoid, hematopoietic and related tissue
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is D47.Z9 an HCC code?
Yes. D47.Z9 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.Z9
For D47.Z9 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.Z9 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
D47.Z9 is the ICD-10-CM diagnosis code for other specified neoplasms of uncertain behavior of lymphoid, hematopoietic and related tissue. Other abnormal growths of blood and lymphoid tissue that have uncertain potential to become cancer and don't fit into other specific categories. D47.Z9 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.Z9 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.Z9 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.
This is a catch-all code; use only when a more specific code from D47 series is not applicable. Because D47.Z9 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.Z9 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This is a catch-all code; use only when a more specific code from D47 series is not applicable
- •Document the specific diagnosis and pathologic findings that support the uncertain behavior classification
Clinical Significance
This code captures neoplasms of uncertain behavior in lymphoid and hematopoietic tissue that defy more specific classification within the D47 series. These conditions represent clonal hematologic processes where the biological behavior -- whether indolent or aggressive -- remains undetermined, requiring close hematologic surveillance. Accurate capture is critical because misclassifying these as benign or definitively malignant alters treatment planning and risk stratification.
Documentation Requirements
- ✓Documentation must include the pathologic diagnosis with histologic findings supporting uncertain behavior classification, the anatomic site or tissue type involved, and the basis for excluding more specific D47 subcategories.
- ✓Include biopsy or bone marrow results, flow cytometry findings, and current treatment or monitoring plan.
- ✓Provider attestation of ongoing clinical relevance each encounter is required for recapture.
Commonly Confused Codes
- •D47.Z9 vs. D47.1 (Chronic myeloproliferative disease) -
- •use D47.1 when a specific myeloproliferative neoplasm is diagnosed. D47.Z9 vs. C96.9 (Malignant neoplasm of lymphoid/hematopoietic tissue, unspecified) -
- •use C96.9 when behavior is confirmed malignant. D47.Z9 vs. D75.89 (Other specified diseases of blood) -
- •D75.89 is for non-neoplastic hematologic disorders.