ICD-10 Code D46.22 – Refractory anemia with excess of blasts 2 (2026): Diagnosis, Symptoms & Billing Guide

The ICD-10 code for Refractory anemia with excess of blasts 2 is D46.22.
2026 ICD-10-CM Diagnosis Code D46.22 – Refractory anemia with excess of blasts 2

What it is

D46.22 identifies a myelodysplastic syndrome with refractory anemia and excess blasts, type 2. It is used when the record specifically documents this subtype of MDS.

Clinical signs

Clinical features vary; refer to documentation. Commonly, patients have persistent cytopenias and bone marrow findings showing increased blasts consistent with this MDS subtype.

When to use this code

Use D46.22 when the provider documents refractory anemia with excess of blasts 2, R.A.E.B.-2, or an equivalent confirmed diagnosis. Code it from the final assessment, pathology, or hematology note when the subtype is clearly stated. Check documentation if the record only says myelodysplastic syndrome.

Do not use for

Do not use this code for unspecified myelodysplastic syndrome or other MDS subtypes. Do not assume the diagnosis from anemia alone; check documentation.

Coding tip

Verify the exact MDS subtype in the provider’s final diagnosis before assigning D46.22.

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