ICD-10 Coding for MGUS(D47.2)
Complete ICD-10-CM coding and documentation guide for MGUS. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to MGUS
D47.2Primary Range
Monoclonal gammopathy
Primary code for MGUS, used to identify monoclonal gammopathy without CRAB features.
Multiple myeloma
Used when CRAB features are present, indicating progression to multiple myeloma.
Key Information: ICD-10 code for MGUS
Essential facts and insights about MGUS
Primary ICD-10-CM Code for mgus
Decision Criteria
clinical Criteria
- No CRAB features present
coding Criteria
- Use D47.2 for MGUS without progression
documentation Criteria
- Document serum protein levels and absence of CRAB features
Applicable To
- MGUS
Excludes
- Multiple myeloma (C90.0)
Clinical Validation Requirements
- Serum monoclonal protein <3 g/dL
- Bone marrow plasma cells <10%
- Absence of CRAB features
Code-Specific Risks
- Undercoding if CRAB features are present
- Overcoding if used for polyclonal conditions
Coding Notes
- Ensure documentation clearly states absence of CRAB features.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting MGUS to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code D47.2.
Impact
Clinical: Misclassification of the condition., Regulatory: Potential audit issues., Financial: Denial of claims due to insufficient documentation.
Mitigation Strategy
Always include specific lab results in documentation.
Impact
Reimbursement: Incorrect DRG assignment can affect reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Use C90.0 if CRAB features are present.
Impact
Failure to document absence of CRAB features can lead to incorrect coding.
Mitigation Strategy
Ensure thorough documentation of lab results and clinical findings.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for MGUS, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for MGUS
Use these documentation templates to ensure complete and accurate documentation for MGUS. These templates include all required elements for proper coding and billing.
Asymptomatic MGUS monitoring
Specialty: HematologyRequired Elements
- Serum protein levels
- Absence of CRAB features
- Monitoring plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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