ICD-10 Code D46.B – Refractory cytopenia with multilineage dysplasia and ring sideroblasts (2026): Diagnosis, Symptoms & Billing Guide

The ICD-10 code for Refractory cytopenia with multilineage dysplasia and ring sideroblasts is D46.B.
2026 ICD-10-CM Diagnosis Code D46.B – Refractory cytopenia with multilineage dysplasia and ring sideroblasts

What it is

D46.B identifies a myelodysplastic syndrome with low blood counts, dysplasia in more than one cell line, and ring sideroblasts in the marrow. It reflects ineffective blood cell production rather than simple anemia.

Clinical signs

Clinical features vary; refer to documentation. Common findings include persistent cytopenias, marrow dysplasia, and ring sideroblasts confirmed on bone marrow examination.

When to use this code

Use D46.B when the provider documents refractory cytopenia with multilineage dysplasia and ring sideroblasts, or clearly identifies this specific myelodysplastic syndrome subtype. Code it from the finalized diagnosis, not from isolated abnormal blood counts alone.

Do not use for

Do not use this code for unspecified anemia, isolated sideroblastic anemia, or other myelodysplastic syndromes without the documented combination of multilineage dysplasia and ring sideroblasts. Check documentation if the subtype is unclear.

Coding tip

Verify the exact MDS subtype in the pathology or hematology note before assigning D46.B.

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