ICD-10 Code D46.4 – Refractory anemia, unspecified (2026): Diagnosis, Symptoms & Billing Guide
2026 ICD-10-CM Diagnosis Code D46.4 – Refractory anemia, unspecified
What it is
D46.4 identifies refractory anemia when the record does not specify a subtype. It refers to a persistent anemia that does not respond as expected to usual management, and the exact cause or marrow category is not further defined.
Clinical signs
Typical findings include chronic anemia with fatigue, weakness, pallor, or shortness of breath. Clinical features vary; refer to documentation, and confirm whether the provider documents refractory anemia without a more specific diagnosis.
When to use this code
Use D46.4 when the provider documents refractory anemia and does not name a more specific form, such as a subtype of myelodysplastic syndrome or another defined anemia. It is appropriate when the chart clearly supports a refractory pattern but lacks further detail. Check documentation if the cause is uncertain.
Do not use for
Do not use this code for anemia with a documented specific cause, such as iron deficiency, blood loss, or chronic disease. Also avoid it when the record identifies a more specific myelodysplastic syndrome code.
Coding tip
Query the provider if “refractory anemia” is mentioned without detail, because a more specific diagnosis may change code selection.