ICD-10 Code D46.1 – Refractory anemia with ring sideroblasts (2026): Diagnosis, Symptoms & Billing Guide
2026 ICD-10-CM Diagnosis Code D46.1 – Refractory anemia with ring sideroblasts
What it is
D46.1 identifies refractory anemia with ring sideroblasts, a myelodysplastic syndrome marked by ineffective red blood cell production. The bone marrow shows ring sideroblasts, and the anemia may not respond well to standard measures.
Clinical signs
Common findings include persistent anemia, fatigue, and marrow evidence of ring sideroblasts. Clinical features vary; refer to documentation for the specific subtype, severity, and any associated cytopenias.
When to use this code
Use D46.1 when the provider documents refractory anemia with ring sideroblasts or an equivalent diagnosis of myelodysplastic syndrome with ring sideroblasts. Code it when the record supports the condition as the confirmed reason for evaluation, monitoring, or treatment. If the documentation is unclear, check documentation.
Do not use for
Do not use this code for anemia without documented ring sideroblasts or for other myelodysplastic syndromes. Avoid using it when the chart only says “possible” or “rule out” refractory anemia with ring sideroblasts.
Coding tip
Confirm that the provider documents ring sideroblasts or the exact MDS subtype before assigning D46.1.