ICDcodes.org
FY2027

C93 vs D46.Z

C93 and D46.Z can never be reported together. ICD-10-CM declares them mutually exclusive with an Excludes1 note, meaning the two conditions cannot occur in the same patient — so exactly one of them is correct for any given encounter.

The official note, declared on D46.Z
chronic myelomonocytic leukemia (C93.1-)
C93

Monocytic leukemia

Not billable
Chapter 2
Neoplasms
Section
C81-C96
Use when the record says
  • monocytoid leukemia
D46.Z

Other myelodysplastic syndromes

Billable
Chapter 2
Neoplasms
Section
D37-D48
Indexed under
  • Myelodysplasia › specified NEC
  • Myelodysplastic syndrome › specified NEC
  • Syndrome › myelodysplastic › specified NEC

Excludes1 is not always absolute: where two conditions covered by the note are genuinely unrelated, CMS guidance permits reporting both. Document the reasoning rather than assuming it. More on Excludes1 vs Excludes2 · FY2027