ICD10BillableValid for clinical use
ICD-10 Code D46.4: Refractory anemia, unspecified
Reviewed by HealthAssure Clinical TeamUpdated 26 May 2026
What is this code?
ICD-10 codes are diagnosis classification codes used in healthcare records, reporting, coding workflows, and billing support. This code sits within the broader ICD-10 area for Neoplasms (C00-D49).
When is it used?
- May be used when a clinician documents refractory anemia, unspecified in a patient's medical record.
- May appear in hospital records, claims, referrals, and clinical documentation.
- This code can be used as a clinically usable diagnosis entry in standardized coding workflows.
What it does not mean
- A code alone does not explain severity, treatment plan, or outcome.
- A medical code should not be treated as a substitute for a doctor's diagnosis or advice.
Code hierarchy
chapter
2Neoplasms (C00-D49)
block
D37-D48Neoplasms of uncertain behavior, polycythemia vera and myelodysplastic syndromes
category
D46Myelodysplastic syndromes
currentD46
Where you may see this code
You may see this code in hospital records, discharge summaries, insurance claims, encounter documentation, referrals, or other healthcare billing and coding records.
Related specialists
OncologistGeneral PhysicianHematologist
Related codes
D46.0Refractory anemia without ring sideroblasts, so statedcodeD46.1Refractory anemia with ring sideroblastscodeD46.2Refractory anemia with excess of blasts [RAEB]categoryD46.ARefractory cytopenia with multilineage dysplasiacodeD46.BRefractory cytopenia with multilineage dysplasia and ring sideroblastscodeD46.CMyelodysplastic syndrome with isolated del(5q) chromosomal abnormalitycodeD46.ZOther myelodysplastic syndromescodeD46.9Myelodysplastic syndrome, unspecifiedcode
Sibling codes
D46.0Refractory anemia without ring sideroblasts, so statedbillableD46.1Refractory anemia with ring sideroblastsbillableD46.2Refractory anemia with excess of blasts [RAEB]D46.ARefractory cytopenia with multilineage dysplasiabillableD46.BRefractory cytopenia with multilineage dysplasia and ring sideroblastsbillableD46.CMyelodysplastic syndrome with isolated del(5q) chromosomal abnormalitybillableD46.ZOther myelodysplastic syndromesbillableD46.9Myelodysplastic syndrome, unspecifiedbillable
Coverage-related procedures and services
CPT 81479high
UNLISTED MOLECULAR PATHOLOGY PROCEDURE
Source: CMS coverage guidance
CPT 81450high
HEMATOLYMPHOID NEOPLASM OR DISORDER, GENOMIC SEQUENCE ANALYSIS PANEL, 5-50 GENES, INTERROGATION FOR SEQUENCE VARIANTS, AND COPY NUMBER VARIANTS OR REARRANGEMENTS, OR ISOFORM EXPRESSION OR MRNA EXPRESSION LEVELS, IF PERFORMED; DNA ANALYSIS OR COMBINED DNA AND RNA ANALYSIS
Source: CMS coverage guidance
CPT 81451high
HEMATOLYMPHOID NEOPLASM OR DISORDER, GENOMIC SEQUENCE ANALYSIS PANEL, 5-50 GENES, INTERROGATION FOR SEQUENCE VARIANTS, AND COPY NUMBER VARIANTS OR REARRANGEMENTS, OR ISOFORM EXPRESSION OR MRNA EXPRESSION LEVELS, IF PERFORMED; RNA ANALYSIS
Source: CMS coverage guidance
CPT 88182high
FLOW CYTOMETRY, CELL CYCLE OR DNA ANALYSIS
Source: CMS coverage guidance
CPT 88185high
FLOW CYTOMETRY, CELL SURFACE, CYTOPLASMIC, OR NUCLEAR MARKER, TECHNICAL COMPONENT ONLY; EACH ADDITIONAL MARKER (LIST SEPARATELY IN ADDITION TO CODE FOR FIRST MARKER)
Source: CMS coverage guidance
CPT 88184high
FLOW CYTOMETRY, CELL SURFACE, CYTOPLASMIC, OR NUCLEAR MARKER, TECHNICAL COMPONENT ONLY; FIRST MARKER
Source: CMS coverage guidance
Coding guidelines
Compatibility
Legacy and official ICD code match exactly.
Legacy codes
D46.4
Common synonyms
Refractory anemia, unspecifiedRefractory anemia
Frequently asked questions
About this content
This page is prepared by HealthAssure's clinical team using official coding standards from ICD-10. AI tools assist with drafting explanations, which are then reviewed and verified by healthcare professionals for accuracy. This content is for informational purposes and does not replace professional medical advice. Meet our team.