D46.4 — Refractory anemia, unspecified
D46.4 is a billable, specific ICD-10-CM code for refractory anemia, unspecified. It is valid for submission on a claim.
Risk adjustment
D46.4 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
D46.4 is named in 40 Medicare coverage policies — 40 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 D46.4 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 D46.4.
- Anemia›refractory
Related codes at this level
Codes that share D46. If D46.4 is not quite right, the correct code is usually one of these.
- D46.0Refractory anemia without ring sideroblasts, so stated
- D46.1Refractory anemia with ring sideroblasts
- D46.2Refractory anemia with excess of blasts [RAEB]
- D46.ARefractory cytopenia with multilineage dysplasia
- D46.BRefractory cytopenia with multilineage dysplasia and ring sideroblasts
- D46.CMyelodysplastic syndrome with isolated del(5q) chromosomal abnormality
- D46.ZOther myelodysplastic syndromes
- D46.9Myelodysplastic syndrome, unspecified
Questions about D46.4
- Is D46.4 a billable ICD-10-CM code?
- Yes. D46.4 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does D46.4 sit in the tabular list?
- Neoplasms (C00-D49), in the block Neoplasms of uncertain behavior, polycythemia vera and myelodysplastic syndromes (D37-D48).