Myelodysplastic syndromes (D46) ICD-10-CM
The D46 code range covers myelodysplastic syndromes with 13 ICD-10-CM diagnosis codes. 11 of them are billable and valid for claim submission in fiscal year 2027, and the category headers group them but cannot themselves be billed.
Use Additional Code
The “use additional code” indicates that a secondary code could be used to further specify the patient’s condition. This note is not mandatory and is only used if enough information is available to assign an additional code.
Type 2 Excludes
A type 2 excludes note represents "Not included here". An excludes2 note indicates that the condition excluded is not part of the condition represented by the code, but a patient may have both conditions at the same time. When an Excludes2 note appears under a code, it is acceptable to use both the code and the excluded code together, when appropriate.
- drug-induced aplastic anemia D61.1
Codes in the D46 Range 13 codes · 11 billable
- D46 Myelodysplastic syndromesNon-billable
- 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]Non-billable
- 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
- D46.Z Other myelodysplastic syndromes
Clinical Terms in This Code Range
Definitions from the National Library of Medicine for conditions coded in the D46 range.
Anemia, Refractory
A severe sometimes chronic anemia, usually macrocytic in type, that does not respond to ordinary antianemic therapy.
Anemia, Refractory, with Excess of Blasts
Chronic refractory anemia with granulocytopenia, and/or thrombocytopenia. Myeloblasts and progranulocytes constitute 5 to 40 percent of the nucleated marrow cells.
Myelodysplastic Syndrome with Excess Blasts
Myelodysplastic syndrome characterized by the presence of 5-9% blasts in bone marrow and 2-9% blasts in peripheral blood.
Myelodysplastic Syndrome with Isolated del(5q)
A myelodysplastic syndrome characterized by a deletion between bands q31 and 33 on chromosome 5. The number of blasts in the bone marrow and blood is <5%. The bone marrow is usually hypercellular or normocellular with increased number of often hypolobated megakaryocytes. The peripheral blood shows macrocytic anemia. This syndrome occurs predominantly but not exclusively in middle age to older women. The prognosis is good and transformation to acute leukemia is rare. (WHO, 2001)
Myelodysplastic Syndrome with Multilineage Dysplasia
A myelodysplastic syndrome characterized by bi-cytopenia or pancytopenia and dysplastic changes in 10% or more of the cells in two or more of the myeloid cell lines. (WHO, 2001)
Myelodysplastic Syndrome with Ring Sideroblasts
A myelodysplastic syndrome characterized by an anemia in which 15% or more of the erythroid precursors are ring sideroblasts. The ring sideroblast is an erythroid precursor in which one third or more of the nucleus is encircled by granules which are positive for iron stain. (WHO, 2001)
Myelodysplastic Syndrome with Ring Sideroblasts and Multilineage Dysplasia
A myelodysplastic syndrome characterized by bi-cytopenia or pancytopenia, dysplastic changes in 10% or more of the cells in two or more of the myeloid cell lines, and 15% or more ring sideroblasts in the bone marrow. (WHO, 2001)
Myelodysplastic Syndrome/Acute Myeloid Leukemia
A myelodysplastic syndrome characterized by the presence of dysplasia in one or more hematopoietic cell lineages and 10-19% blasts in bone marrow or peripheral blood.
Myelodysplastic Syndromes
Clonal hematopoietic stem cell disorders characterized by dysplasia in one or more hematopoietic cell lineages. They predominantly affect patients over 60, are considered preleukemic conditions, and have high probability of transformation into ACUTE MYELOID LEUKEMIA.
About the D46 Code Range
Myelodysplastic syndromes involve abnormal development in one or more lines of blood-forming cells.
The refractory anemia subdivisions distinguish ring sideroblasts, excess blasts, and cases without further detail. Excess blasts split into unspecified, level 1, and level 2.
Other subdivisions identify refractory cytopenia with multilineage dysplasia, with a separate code when ring sideroblasts are noted. D46.C names an isolated del(5q) chromosomal abnormality. D46.9 and D46.Z cover unspecified and other myelodysplastic syndromes.
Questions About This Page
How many billable codes are in the D46 range?
Of the 13 codes in this range, 11 are billable and valid for claim submission from October 1, 2026 through September 30, 2027. Category header codes group them but cannot be reported on claims.
What does the D46 range classify?
The range classifies myelodysplastic syndromes. Each code links to its own reference page with billing status, MS-DRG grouping, coding notes, and clinical information.
Related References
Source: CMS FY 2027 ICD-10-CM Tabular List and order file, effective October 1, 2026 through September 30, 2027.
