ICD-10 Coding for Monoclonal Gammopathy(D47.2, C90.0)
Complete ICD-10-CM coding and documentation guide for Monoclonal Gammopathy. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Monoclonal Gammopathy
D47.2Primary Range
Neoplasms of uncertain behavior of lymphoid, hematopoietic and related tissue
Primary code for monoclonal gammopathy of undetermined significance (MGUS).
Polyclonal hypergammaglobulinemia
Differential diagnosis for conditions with elevated immunoglobulins.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| D47.2 | Monoclonal gammopathy | Use when MGUS is the primary focus of care and CRAB symptoms are absent. |
|
| C90.0 | Multiple myeloma | Use when CRAB symptoms are present and M-protein is ≥3g/dL. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for monoclonal gammopathy
Essential facts and insights about Monoclonal Gammopathy
Primary ICD-10-CM Codes for monoclonal gammopathy
Decision Criteria
clinical Criteria
- M-protein <3g/dL and <10% plasma cells
documentation Criteria
- Absence of CRAB symptoms must be documented
Applicable To
- Monoclonal gammopathy of undetermined significance (MGUS)
Excludes
- Multiple myeloma (C90.0)
Clinical Validation Requirements
- M-protein <3g/dL
- <10% plasma cells in bone marrow
- Absence of CRAB symptoms
Code-Specific Risks
- Incorrectly coding MGUS as multiple myeloma without CRAB symptoms.
Coding Notes
- Ensure documentation supports the absence of CRAB symptoms.
C90.0 - Multiple myeloma
Use when CRAB symptoms are present and M-protein is ≥3g/dL.
Excludes
- MGUS (D47.2)
Clinical Validation Requirements
- M-protein ≥3g/dL
- Presence of CRAB symptoms
Coding Notes
Ensure CRAB symptoms are documented.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Glomerular disorders in diseases classified elsewhere
N08.3Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Monoclonal Gammopathy to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code D47.2.
Impact
Clinical: Leads to potential misdiagnosis., Regulatory: Non-compliance with coding standards., Financial: May result in claim denials.
Mitigation Strategy
Always document specific M-protein levels.
Impact
Reimbursement: Incorrect sequencing can affect DRG assignment and reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Sequence renal condition as primary if it is the focus of care, with D47.2 as secondary.
Impact
Risk of audits due to insufficient documentation of CRAB exclusion.
Mitigation Strategy
Ensure CRAB symptoms are explicitly documented as absent.
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 Monoclonal Gammopathy, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Monoclonal Gammopathy
Use these documentation templates to ensure complete and accurate documentation for Monoclonal Gammopathy. These templates include all required elements for proper coding and billing.
MGUS monitoring visit
Specialty: HematologyRequired Elements
- M-protein quantification
- Bone marrow plasma cell percentage
- CRAB symptom exclusion
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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