Is D46.1 a billable ICD-10-CM code?

Yes. D46.1 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does D46.1 sit in the tabular list?

Neoplasms (C00-D49), in the block Neoplasms of uncertain behavior, polycythemia vera and myelodysplastic syndromes (D37-D48).

D46.1

D46.1 — Refractory anemia with ring sideroblasts

Billable / specific codeICD-10-CM

D46.1 is a billable, specific ICD-10-CM code for refractory anemia with ring sideroblasts. It is valid for submission on a claim.

Inclusion terms

Alternative wordings a physician may use in the chart for this same code.

RARS

Excludes2 inherited from the categories above D46.1

Also inherited, and the opposite of Excludes1: these conditions are not part of D46.1, but a patient can have both, so you may code both.

Written on D46 — Myelodysplastic syndromes

drug-induced aplastic anemia (D61.1)

Other codes that can never be billed with D46.1

These codes carry an Excludes1 note pointing at D46.1. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading D46.1 alone.

C94Other leukemias of specified cell type
D64Other anemias

Risk adjustment

D46.1 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:

HCC 19 Myelodysplastic Syndromes, Multiple Myeloma, and Other Cancers1.798 RAF

Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score.

Medicare coverage

D46.1 is named in 79 Medicare coverage policies — 79 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A52479Oral Anticancer Drugs - Policy Article
A52480Oral Antiemetic Drugs (Replacement for Intravenous Antiemetics) - Policy Article
A52986Billing and Coding: Biomarkers for Oncology
A55717Billing and Coding: Lab: Flow Cytometry

How D46.1 is indexed

Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to D46.1.

Hemochromatosis›with refractory anemia
Anemia›refractory›sideroblastic
Anemia›sideroblastic›refractory
Anemia›refractory›with›hemochromatosis
Anemia›refractory›with›sideroblasts(ring) (RARS)

Code history

D46.1 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Related codes at this level

Codes that share D46. If D46.1 is not quite right, the correct code is usually one of these.

Questions about D46.1

Is D46.1 a billable ICD-10-CM code?: Yes. D46.1 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does D46.1 sit in the tabular list?: Neoplasms (C00-D49), in the block Neoplasms of uncertain behavior, polycythemia vera and myelodysplastic syndromes (D37-D48).