D46.Z: Other myelodysplastic syndromes
D46.Z, other myelodysplastic syndromes, is listed as a covered diagnosis in 6 Medicare billing and coding articles that apply to 50 HCPCS Level II codes, including J0881 (Injection, darbepoetin alfa, 1 microgram (non-esrd use)), J0885 (Injection, epoetin alfa, (for non-esrd use), 1000 units), Q5106 (Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for…). The articles come from 4 Medicare contractors. A listed diagnosis supports medical necessity only; coverage still depends on the LCD's criteria and on documentation in the medical record.
HCPCS Level II codes with D46.Z as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| J0881 | Injection, darbepoetin alfa, 1 microgram (non-esrd use) | Special coverage instructions apply | — | 3 |
| J0885 | Injection, epoetin alfa, (for non-esrd use), 1000 units | Special coverage instructions apply | — | 3 |
| Q5106 | Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for non-esrd use), 1000 units | Special coverage instructions apply | — | 3 |
| J0882 | Injection, darbepoetin alfa, 1 microgram (for esrd on dialysis) | Special coverage instructions apply | — | 3 |
| J0888 | Injection, epoetin beta, 1 microgram, (for non esrd use) | Special coverage instructions apply | — | 3 |
| Q5105 | Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for esrd on dialysis), 100 units | Special coverage instructions apply | — | 3 |
| J0887 | Injection, epoetin beta, 1 microgram, (for esrd on dialysis) | Special coverage instructions apply | — | 3 |
| J0890 | Injection, peginesatide, 0.1 mg (for esrd on dialysis) | Carrier judgment | — | 3 |
| Q4081 | Injection, epoetin alfa, 100 units (for esrd on dialysis) | Special coverage instructions apply | — | 3 |
| Q0512 | Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period | Special coverage instructions apply | — | 2 |
| Q0511 | Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period | Special coverage instructions apply | — | 2 |
| J8999 | Prescription drug, oral, chemotherapeutic, nos | Special coverage instructions apply | — | 1 |
| J8530 | Cyclophosphamide; oral, 25 mg | Special coverage instructions apply | — | 1 |
| J8597 | Antiemetic drug, oral, not otherwise specified | Special coverage instructions apply | — | 1 |
| J8610 | Methotrexate; oral, 2.5 mg | Special coverage instructions apply | — | 1 |
| J8498 | Antiemetic drug, rectal/suppository, not otherwise specified | Special coverage instructions apply | — | 1 |
| Q5110 | Injection, filgrastim-aafi, biosimilar, (nivestym), 1 microgram | Special coverage instructions apply | — | 1 |
| Q5125 | Injection, filgrastim-ayow, biosimilar, (releuko), 1 microgram | Carrier judgment | — | 1 |
| Q5101 | Injection, filgrastim-sndz, biosimilar, (zarxio), 1 microgram | Special coverage instructions apply | — | 1 |
| J1442 | Injection, filgrastim (g-csf), excludes biosimilars, 1 microgram | Special coverage instructions apply | — | 1 |
| J1449 | Injection, eflapegrastim-xnst, 0.1 mg | Carrier judgment | — | 1 |
| J1447 | Injection, tbo-filgrastim, 1 microgram | Special coverage instructions apply | — | 1 |
| Q5108 | Injection, pegfilgrastim-jmdb (fulphila), biosimilar, 0.5 mg | Carrier judgment | — | 1 |
| Q5111 | Injection, pegfilgrastim-cbqv (udenyca), biosimilar, 0.5 mg | Carrier judgment | — | 1 |
| Q5127 | Injection, pegfilgrastim-fpgk (stimufend), biosimilar, 0.5 mg | Carrier judgment | — | 1 |
25 more codes are listed. See every code with payment by region in Caduvo.
Medicare policy articles listing D46.Z
- A56795: Billing and Coding: Erythropoiesis Stimulating Agents (ESAs) (WPS Insurance Corporation (MAC - Part A, MAC - Part B); 9 Level II codes). LCD with the same title: L34633
- A58982: Billing and Coding: Erythropoiesis Stimulating Agents (Palmetto GBA (MAC - Part A, MAC - Part B); 9 Level II codes). LCD with the same title: L39237
- A52479: Oral Anticancer Drugs - Policy Article (CGS Administrators, LLC (DME MAC) Noridian Healthcare Solutions, LLC (DME MAC); 8 Level II codes). LCD with the same title: L33826
- A56748: Billing and Coding: White Cell Colony Stimulating Factors (Palmetto GBA (MAC - Part A, MAC - Part B); 16 Level II codes). LCD with the same title: L37176
- A52480: Oral Antiemetic Drugs (Replacement for Intravenous Antiemetics) - Policy Article (CGS Administrators, LLC (DME MAC) Noridian Healthcare Solutions, LLC (DME MAC); 19 Level II codes). LCD with the same title: L33827
- A60381: Billing and Coding: Erythropoiesis Stimulating Agents (Wellpoint Federal (MAC - Part A, MAC - Part B); 9 Level II codes). LCD with the same title: L39237
A diagnosis listed as covered in a billing and coding article supports medical necessity for the article's codes; it does not guarantee payment. Coverage depends on the LCD's criteria, the contractor's jurisdiction and documentation in the medical record.
Other D46 diagnoses (Myelodysplastic syndromes)
- D46.0 — Refractory anemia without ring sideroblasts, so stated
- D46.1 — Refractory anemia with ring sideroblasts
- 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
- D46.4 — Refractory anemia, unspecified
- D46.9 — Myelodysplastic syndrome, unspecified
- 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
Frequently asked questions
Does Medicare cover D46.Z (Other myelodysplastic syndromes)?
Medicare covers items and services, not diagnoses. 6 Medicare billing and coding articles list D46.Z as a covered diagnosis for 50 HCPCS Level II codes: the diagnosis can support medical necessity for those codes, but payment still depends on the LCD's coverage criteria and the medical record.
Which HCPCS codes can be billed with ICD-10 D46.Z?
The Level II codes from the policies most specific to this diagnosis are J0881 (Injection, darbepoetin alfa, 1 microgram (non-esrd use), 3 articles); J0885 (Injection, epoetin alfa, (for non-esrd use), 1000 units, 3 articles); Q5106 (Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for…, 3 articles); J0882 (Injection, darbepoetin alfa, 1 microgram (for esrd on…, 3 articles); J0888 (Injection, epoetin beta, 1 microgram, (for non esrd use), 3 articles). Code choice depends on the item supplied; check each code's descriptor.
Which Medicare policy articles list D46.Z?
A56795 (Billing and Coding: Erythropoiesis Stimulating Agents (ESAs)); A58982 (Billing and Coding: Erythropoiesis Stimulating Agents); A52479 (Oral Anticancer Drugs - Policy Article), and 3 more articles.
What is ICD-10-CM code D46.Z?
D46.Z is the ICD-10-CM code for other myelodysplastic syndromes, in category D46 (Myelodysplastic syndromes), chapter 2: Neoplasms.
Next steps
- Run a reimbursement report for a device billed under J0881
- Watch J0881 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J0881
Sources: CMS Medicare Coverage Database billing and coding articles (covered ICD-10 code lists and HCPCS links); ICD-10-CM FY2026; CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule 2026 (non-rural state fees). Not billing or legal advice.