2017/18 ICD-10-CM Diagnosis Code D46

Myelodysplastic syndromes

Use Additional
Use Additional Help
Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. For such conditions the ICD-10-CM has a coding convention that requires the underlying condition be sequenced first followed by the manifestation. Wherever such a combination exists there is a "use additional code" note at the etiology code, and a "code first" note at the manifestation code. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. In most cases the manifestation codes will have in the code title, "in diseases classified elsewhere." Codes with this title are a component of the etiology/manifestation convention. The code title indicates that it is a manifestation code. "In diseases classified elsewhere" codes are never permitted to be used as first listed or principle diagnosis codes. They must be used in conjunction with an underlying condition code and they must be listed following the underlying condition.
  • code for adverse effect, if applicable, to identify drug (T36-T50
    ICD-10-CM Range T36-T50

    Poisoning by, adverse effect of and underdosing of drugs, medicaments and biological substances

    Code First
    • , for adverse effects, the nature of the adverse effect, such as:
    • adverse effect NOS (T88.7 )
    • aspirin gastritis (K29.-)
    • blood disorders (D56-D76 )
    • contact dermatitis (L23-L25 )
    • dermatitis due to substances taken internally (L27.-)
    • nephropathy (N14.0-N14.2)
    Includes
    • adverse effect of correct substance properly administered
    • poisoning by overdose of substance
    • poisoning by wrong substance given or taken in error
    • underdosing by (inadvertently) (deliberately) taking less substance than prescribed or instructed
    Note
    • The drug giving rise to the adverse effect should be identified by use of codes from categories T36-T50 with fifth or sixth character 5.
    Type 1 Excludes
    • toxic reaction to local anesthesia in pregnancy (O29.3-)
    Type 2 Excludes
    • abuse and dependence of psychoactive substances (F10-F19)
    • abuse of non-dependence-producing substances (F55.-)
    • drug reaction and poisoning affecting newborn (P00-P96)
    • pathological drug intoxication (inebriation) (F10-F19)
    Use Additional
    • code(s) to specify:
    • manifestations of poisoning
    • underdosing or failure in dosage during medical and surgical care (Y63.6, Y63.8-Y63.9)
    • underdosing of medication regimen (Z91.12-, Z91.13-)
    • T36 Poisoning by, adverse effect of and unde...
    • T37 Poisoning by, adverse effect of and unde...
    • T38 Poisoning by, adverse effect of and unde...
    • T39 Poisoning by, adverse effect of and unde...
    • T40 Poisoning by, adverse effect of and unde...
    • T41 Poisoning by, adverse effect of and unde...
    • T42 Poisoning by, adverse effect of and unde...
    • T43 Poisoning by, adverse effect of and unde...
    • T44 Poisoning by, adverse effect of and unde...
    • T45 Poisoning by, adverse effect of and unde...
    • T46 Poisoning by, adverse effect of and unde...
    • T47 Poisoning by, adverse effect of and unde...
    • T48 Poisoning by, adverse effect of and unde...
    • T49 Poisoning by, adverse effect of and unde...
    • T50 Poisoning by, adverse effect of and unde...
    with fifth or sixth character 5)
Type 2 Excludes
Type 2 Excludes Help
A type 2 excludes note represents "not included here". A type 2 excludes note indicates that the condition excluded is not part of the condition it is excluded from but a patient may have both conditions at the same time. When a type 2 excludes note appears under a code it is acceptable to use both the code (D46) and the excluded code together.
  • drug-induced aplastic anemia (
    ICD-10-CM Diagnosis Code D61.1

    Drug-induced aplastic anemia

      2016 2017 2018 Billable/Specific Code
    Use Additional
    • code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5)
    D61.1
    )
The following code(s) above D46 contain annotation back-references
Annotation Back-References
In this context, annotation back-references refer to codes that contain:
  • Applicable To annotations, or
  • Code Also annotations, or
  • Code First annotations, or
  • Excludes1 annotations, or
  • Excludes2 annotations, or
  • Includes annotations, or
  • Note annotations, or
  • Use Additional annotations
that may be applicable to D46:
  • C00-D49
    2018 ICD-10-CM Range C00-D49

    Neoplasms

    Note
    • Functional activity
    • All neoplasms are classified in this chapter, whether they are functionally active or not. An additional code from Chapter 4 may be used, to identify functional activity associated with any neoplasm.
    • Morphology [Histology]
    • Chapter 2 classifies neoplasms primarily by site (topography), with broad groupings for behavior, malignant, in situ, benign, etc. The Table of Neoplasms should be used to identify the correct topography code. In a few cases, such as for malignant melanoma and certain neuroendocrine tumors, the morphology (histologic type) is included in the category and codes.
    • Primary malignant neoplasms overlapping site boundaries
    • A primary malignant neoplasm that overlaps two or more contiguous (next to each other) sites should be classified to the subcategory/code .8 ('overlapping lesion'), unless the combination is specifically indexed elsewhere. For multiple neoplasms of the same site that are not contiguous, such as tumors in different quadrants of the same breast, codes for each site should be assigned.
    • Malignant neoplasm of ectopic tissue
    • Malignant neoplasms of ectopic tissue are to be coded to the site mentioned, e.g., ectopic pancreatic malignant neoplasms are coded to pancreas, unspecified (C25.9).
    Neoplasms
  • D37-D48
    2018 ICD-10-CM Range D37-D48

    Neoplasms of uncertain behavior, polycythemia vera and myelodysplastic syndromes

    Note
    • Categories D37-D44, and D48 classify by site neoplasms of uncertain behavior, i.e., histologic confirmation whether the neoplasm is malignant or benign cannot be made.
    Type 1 Excludes
    • neoplasms of unspecified behavior (D49.-)
    Neoplasms of uncertain behavior, polycythemia vera and myelodysplastic syndromes
Clinical Information Code History
Code annotations containing back-references to D46:
ICD-10-CM Codes Adjacent To D46
D44.11 Neoplasm of uncertain behavior of right adrenal gland
D44.12 Neoplasm of uncertain behavior of left adrenal gland
D44.2 Neoplasm of uncertain behavior of parathyroid gland
D44.3 Neoplasm of uncertain behavior of pituitary gland
D44.4 Neoplasm of uncertain behavior of craniopharyngeal duct
D44.5 Neoplasm of uncertain behavior of pineal gland
D44.6 Neoplasm of uncertain behavior of carotid body
D44.7 Neoplasm of uncertain behavior of aortic body and other paraganglia
D44.9 Neoplasm of uncertain behavior of unspecified endocrine gland
D45 Polycythemia vera
D46 Myelodysplastic syndromes
D46.0 Refractory anemia without ring sideroblasts, so stated
D46.1 Refractory anemia with ring sideroblasts
D46.2 Refractory anemia with excess of blasts [RAEB]
D46.20 Refractory anemia with excess of blasts, unspecified
D46.21 Refractory anemia with excess of blasts 1
D46.22 Refractory anemia with excess of blasts 2
D46.A Refractory cytopenia with multilineage dysplasia
D46.B Refractory cytopenia with multilineage dysplasia and ring sideroblasts
D46.C Myelodysplastic syndrome with isolated del(5q) chromosomal abnormality
D46.4 Refractory anemia, unspecified

Reimbursement claims with a date of service on or after October 1, 2015 require the use of ICD-10-CM codes.