What is ICD-10 code D75.81?

D75.81 is the ICD-10-CM diagnosis code for Myelofibrosis. A condition where bone marrow becomes scarred and fibrotic, leading to reduced blood cell production and potential anemia or bleeding problems. D75.81 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. D75.81 is part of the FY2026 ICD-10-CM code set published by the CMS National Center for Health Statistics and used on Medicare, Medicaid, and commercial claims in the United States.

Yes. D75.81 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. D75.81 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

Which HCC does D75.81 map to under V28?

D75.81 maps to CMS-HCC V28 HCC 19 (Myelodysplastic Syndromes, Multiple Myeloma, and Other Cancers). The category numbers, labels, and conditions come from the CMS-HCC V28 model file for payment year 2026.

2026 ICD-10-CM D75.81: Myelofibrosis

D75.81 maps to CMS-HCC V28 19. A source-labeled RAF reference is available. Documentation must support MEAT. MEAT criteria · RAF Calculator · HCC Buddy coding tools

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Code lookupD75.81Effective periodFY2026 Apr Update (Apr 1-Sep 30)

FY 2026 Apr update / Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism (D50-D89) / Other disorders of blood and blood-forming organs (D70-D77)

D75.81

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Myelofibrosis

A condition where bone marrow becomes scarred and fibrotic, leading to reduced blood cell production and potential anemia or bleeding problems.

Buddy Insight

Myelofibrosis is a chronic myeloproliferative neoplasm characterized by progressive bone marrow fibrosis, extramedullary hematopoiesis (splenomegaly, hepatomegaly), and peripheral blood cytopenias.

CMS-HCC V28

Mapped

HCC 19

Myelodysplastic Syndromes, Mu...

Code-level coefficient reference

CMS-HCC V24

Historical

Not used for standard CY2026 Medicare Advantage payment. Select a historical period to review V24.

Not used for CY2026 payment

ACA/HHS

Mapped

HCC 067

HHS-HCC 067 adult, RAF varies...

Code-level coefficient reference

ESRD/PACE

Mapped

HCC 46

Severe Hematological Disorders

Code-level coefficient reference

RXHCC

Mapped

HCC 16

Multiple Myeloma and Other He...

Code-level coefficient reference

Code Book Path

Official

D75Other and unspecified diseases of blood and blood-forming organs

D75.8Other specified diseases of blood and blood-forming organs

D75.81Myelofibrosis

Inclusion Terms

Official

Myelofibrosis NOS
Secondary myelofibrosis NOS

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for D75.81 in this effective period.

Related Child Codes

Official

D75.82Heparin induced thrombocytopenia (HIT)

D75.83Thrombocytosis

D75.84Other platelet-activating anti-PF4 disorders

D75.89Other specified diseases of blood and blood-forming organs

Includes

Official

ICD-10-CM does not list Includes notes for D75.81 in this effective period.

Excludes 1

Official

acute myelofibrosis (C94.4-)
idiopathic myelofibrosis (D47.1)
leukoerythroblastic anemia (D61.82)
myelofibrosis with myeloid metaplasia (D47.4)
myelophthisic anemia (D61.82)

Code First

Official

the underlying disorder, such as:
malignant neoplasm of breast (C50.-)

Use Additional

Official

code, if applicable, for associated therapy-related myelodysplastic syndrome (D46.-)

Code Also

Official

ICD-10-CM does not list Code Also instructions for D75.81 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

Document bone marrow biopsy findings showing fibrosis grading (MF-0 to MF-3), driver mutation status (JAK2 V617F, CALR, MPL), complete blood count with differential, peripheral blood smear findings (leukoerythroblastic picture, teardrop cells), spleen size, and prognostic risk score (DIPSS, MIPSS70).

Record current treatment (JAK inhibitors like ruxolitinib, transfusion support, hydroxyurea).

MEAT Support

HCC Buddy guidance

Record current treatment (JAK inhibitors like ruxolitinib, transfusion support, hydroxyurea).

Audit Caution

HCC Buddy guidance

Distinguish primary myelofibrosis from secondary myelofibrosis (post-polycythemia vera or post-essential thrombocythemia) — the underlying MPN should be coded as well.

Do not confuse with reactive marrow fibrosis from metastatic carcinoma, autoimmune conditions, or infections.

Splenomegaly documentation supports the diagnosis but code it separately (R16.1) when clinically significant.

Common Mistakes

HCC Buddy guidance

C94.4x (Acute panmyelosis with myelofibrosis) — acute presentation, not chronic

D47.1 (Chronic myeloproliferative disease, not classified elsewhere) — broader category

C91-C95 (Leukemia codes) — if transformation to AML occurs

D61.9 (Aplastic anemia) — may mimic fibrotic-phase myelofibrosis.

Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →

Is D75.81 an HCC code?

Yes. D75.81 (Myelofibrosis) maps to HCC 19, Myelodysplastic Syndromes, Multiple Myeloma, and Other Cancers under the CMS-HCC V28 risk adjustment model, with a source-labeled community non-dual aged reference coefficient of 1.798. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes. It is billable for payment year 2026.

Coder answer: D75.81 is billable and maps to V28 HCC 19, Myelodysplastic Syndromes, Multiple Myeloma, and Other Cancers. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.

Code: D75.81
Description: Myelofibrosis
HCC (V28): HCC 19 — Myelodysplastic Syndromes, Multiple Myeloma, and Other Cancers
RAF reference coefficient: 1.798
Billable: Yes
Payment year: 2026

HCC Category Mapping

V28HCC 19, Myelodysplastic Syndromes, Multiple Myeloma, and Other Cancers

1.798

ESRDHCC 46, Severe Hematological Disorders

Not separately weighted

RxHCCHCC 16, Multiple Myeloma and Other Hematologic Cancers

Not separately weighted

These are source-labeled model coefficients, not member totals. A category may still be removed by hierarchy or model cleanup rules. Weights are not directly comparable across models: CMS-HCC V28 and V24 use Community, Non-Dual, Aged; ESRD uses the dialysis continuing-enrollee model; RxHCC is the Part D continuing-enrollee, non-low-income, aged weight (a larger scale than CMS-HCC). ACA/HHS has no single weight — it varies by metal level. Actual per-patient RAF contribution depends on member context, hierarchy and cleanup rules, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains available for historical review.

Work D75.81 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT Criteria for D75.81

For D75.81 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 D75.81 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

D75.81 is the ICD-10-CM diagnosis code for myelofibrosis. A condition where bone marrow becomes scarred and fibrotic, leading to reduced blood cell production and potential anemia or bleeding problems. D75.81 sits in the ICD-10-CM chapter for diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism (d50-d89), within the section covering other disorders of blood and blood-forming organs (d70-d77).

Under the CMS-HCC V28 risk adjustment model, D75.81 maps to Myelodysplastic Syndromes, Multiple Myeloma, and Other Cancers (HCC 19) with a source-labeled community, non-dual, aged reference coefficient of 1.798. No V24 mapping is shown for D75.81; use the applicable model and payment year when reviewing the V28 mapping. 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. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes.

Myelofibrosis can be primary or secondary; verify if this is primary myelofibrosis or secondary to another condition. Because D75.81 maps to an HCC category, the provider's documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) before the diagnosis is used for risk adjustment. 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, source-labeled coefficient references, and MEAT documentation criteria for D75.81 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Myelofibrosis can be primary or secondary; verify if this is primary myelofibrosis or secondary to another condition
•Document the stage of myelofibrosis if available, as this affects treatment and prognosis

Clinical Significance

Myelofibrosis is a chronic myeloproliferative neoplasm characterized by progressive bone marrow fibrosis, extramedullary hematopoiesis (splenomegaly, hepatomegaly), and peripheral blood cytopenias. It may be primary (PMF) or secondary to polycythemia vera or essential thrombocythemia. The disease carries risk of transformation to acute myeloid leukemia. JAK2, CALR, or MPL driver mutations are found in approximately 90% of cases.

Documentation Requirements

✓Document bone marrow biopsy findings showing fibrosis grading (MF-0 to MF-3), driver mutation status (JAK2 V617F, CALR, MPL), complete blood count with differential, peripheral blood smear findings (leukoerythroblastic picture, teardrop cells), spleen size, and prognostic risk score (DIPSS, MIPSS70).
✓Record current treatment (JAK inhibitors like ruxolitinib, transfusion support, hydroxyurea).

Excludes 1, Do NOT code together

acute myelofibrosis (C94.4-)
idiopathic myelofibrosis (D47.1)
leukoerythroblastic anemia (D61.82)
myelofibrosis with myeloid metaplasia (D47.4)
myelophthisic anemia (D61.82)
myelophthisis (D61.82)
primary myelofibrosis (D47.1)

Use Additional Code

code, if applicable, for associated therapy-related myelodysplastic syndrome (D46.-)

Code First

the underlying disorder, such as:
malignant neoplasm of breast (C50.-)

Commonly Confused Codes

•C94.4x (Acute panmyelosis with myelofibrosis): acute presentation, not chronic
•D47.1 (Chronic myeloproliferative disease, not classified elsewhere): broader category
•C91-C95 (Leukemia codes): if transformation to AML occurs
•D61.9 (Aplastic anemia): may mimic fibrotic-phase myelofibrosis.