ICD-10 Code D46.A – Refractory cytopenia with multilineage dysplasia (2026): Diagnosis, Symptoms & Billing Guide
2026 ICD-10-CM Diagnosis Code D46.A – Refractory cytopenia with multilineage dysplasia
What it is
D46.A identifies a myelodysplastic syndrome subtype with persistent low blood cell counts and dysplasia in more than one cell line. It reflects abnormal marrow blood formation that is not explained by a simple deficiency or temporary illness.
Clinical signs
Clinical features vary; refer to documentation. Typical findings include anemia, neutropenia, or thrombocytopenia with marrow dysplasia affecting multiple lineages, and the diagnosis is usually confirmed by hematology evaluation and bone marrow studies.
When to use this code
Use D46.A when the record specifically documents refractory cytopenia with multilineage dysplasia or an equivalent myelodysplastic syndrome diagnosis. Apply it for confirmed cases managed as MDS, not for nonspecific cytopenia alone. If the wording is unclear, check documentation before coding.
Do not use for
Do not use this code for isolated anemia, leukopenia, or thrombocytopenia without documented multilineage dysplasia. It is also wrong for reversible cytopenias from infection, drugs, or nutritional deficiency.
Coding tip
Code only when the provider documents the specific MDS subtype; otherwise, query for clarification.