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ICD-10 Guide
ICD-10 CodesD46.0

D46.0

Billable

Refractory anemia without ring sideroblasts, so stated

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/05/2025

Code Description

ICD-10 D46.0 is a billable code used to indicate a diagnosis of refractory anemia without ring sideroblasts, so stated.

Key Diagnostic Point:

Refractory anemia without ring sideroblasts is a type of anemia characterized by a failure of the bone marrow to produce adequate red blood cells despite the presence of sufficient iron stores. This condition is classified under neoplasms of uncertain behavior, indicating that while it is not classified as a malignancy, it has the potential for progression to more severe forms of hematological disorders. Patients typically present with symptoms of anemia such as fatigue, pallor, and weakness. The absence of ring sideroblasts distinguishes this condition from other forms of refractory anemia, particularly those associated with myelodysplastic syndromes. Diagnosis is often confirmed through bone marrow biopsy, which reveals ineffective erythropoiesis and dysplastic changes in hematopoietic cells. Management may include supportive care, blood transfusions, and in some cases, the use of immunosuppressive therapy. Regular surveillance is crucial due to the risk of progression to acute myeloid leukemia (AML) or other hematological malignancies, necessitating close monitoring of blood counts and clinical symptoms.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiation from other types of anemia
  • Need for detailed documentation of symptoms and lab results
  • Potential for progression to more severe conditions
  • Variability in treatment approaches

Audit Risk Factors

  • Inadequate documentation of symptoms
  • Failure to document the absence of ring sideroblasts
  • Lack of follow-up notes indicating ongoing surveillance
  • Misclassification of the condition as a malignancy

Specialty Focus

Medical Specialties

Hematology

Documentation Requirements

Comprehensive documentation of blood counts, bone marrow biopsy results, and treatment plans.

Common Clinical Scenarios

Patients presenting with fatigue and pallor, requiring evaluation of anemia and potential bone marrow disorders.

Billing Considerations

Close monitoring of blood counts and symptoms to assess for progression to more severe conditions.

Oncology

Documentation Requirements

Detailed history of the patient's hematological status and any treatments administered.

Common Clinical Scenarios

Patients with a history of refractory anemia being evaluated for potential progression to leukemia.

Billing Considerations

Understanding the implications of the diagnosis on treatment options and prognosis.

Coding Guidelines

Inclusion Criteria

Use D46.0 When
  • According to ICD
  • 10 coding guidelines, D46
  • 0 should be used when the diagnosis is explicitly stated as refractory anemia without ring sideroblasts
  • It is important to ensure that the documentation supports the diagnosis and that other potential causes of anemia are ruled out

Exclusion Criteria

Do NOT use D46.0 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

85025CPT Code

Complete blood count (CBC) with differential

Clinical Scenario

Used to evaluate the patient's blood counts in the context of refractory anemia.

Documentation Requirements

Document the reason for the CBC and any relevant clinical findings.

Specialty Considerations

Hematologists may require additional tests based on CBC results.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of conditions like refractory anemia, improving the accuracy of diagnoses and treatment tracking. This specificity aids in better patient management and resource allocation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like refractory anemia, improving the accuracy of diagnoses and treatment tracking. This specificity aids in better patient management and resource allocation.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of conditions like refractory anemia, improving the accuracy of diagnoses and treatment tracking. This specificity aids in better patient management and resource allocation.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What distinguishes refractory anemia without ring sideroblasts from other types of anemia?

Refractory anemia without ring sideroblasts is specifically characterized by ineffective erythropoiesis and the absence of ring sideroblasts, which differentiates it from other anemias that may have different underlying causes or morphological features.