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ICD-10 Coding for Myeloma(C90.00, C90.01, C90.02)

Complete ICD-10-CM coding and documentation guide for Myeloma. Includes clinical validation requirements, documentation requirements, and coding pitfalls.

Also known as:

Multiple MyelomaPlasma Cell Myeloma

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Related ICD-10 Code Ranges

Complete code families applicable to Myeloma

C90.0-C90.3Primary Range

Multiple myeloma and malignant plasma cell neoplasms

This range covers the primary ICD-10 codes for multiple myeloma, including active disease, remission, and relapse.

Code Comparison: When to Use Each Code

Compare key differences between these codes to ensure accurate selection

CodeDescriptionWhen to UseKey Documentation
C90.00Multiple myeloma not having achieved remissionUse when the patient has active multiple myeloma with no remission.
  • Serum M-protein ≥0.5 g/dL
  • Bone marrow plasma cells ≥10%
C90.01Multiple myeloma in remissionUse when the patient is in complete remission post-treatment.
  • No detectable M-protein on immunofixation
  • Bone marrow plasma cells <5%
C90.02Multiple myeloma in relapseUse when there is a confirmed relapse of multiple myeloma.
  • ≥25% increase in serum M-protein
  • New plasmacytoma on imaging

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 myeloma

Essential facts and insights about Myeloma

The ICD-10 code for multiple myeloma not having achieved remission is C90.00. For myeloma in remission, use C90.01, and for relapse, use C90.02.

Primary ICD-10-CM Codes for myeloma

C90.00
Multiple myeloma not having achieved remission
Billable Code

Decision Criteria

clinical Criteria

  • Presence of CRAB criteria and elevated M-protein levels.

Applicable To

  • Active multiple myeloma

Excludes

  • Monoclonal gammopathy of undetermined significance (MGUS) (D47.2)

Clinical Validation Requirements

  • Serum M-protein ≥0.5 g/dL
  • Bone marrow plasma cells ≥10%

Code-Specific Risks

  • Incorrectly coding for remission when active disease is present.

Coding Notes

  • Ensure documentation supports active disease status.
View Full Code Details

Ancillary Codes

Additional codes that should be used in conjunction with the main diagnosis codes when applicable.

Hypercalcemia

R17.0
Use when hypercalcemia is present as part of CRAB criteria.

Differential Codes

Alternative codes to consider when ruling out similar conditions to the primary diagnosis.

Monoclonal gammopathy of undetermined significance

D47.2
MGUS is characterized by serum M-protein <3 g/dL and bone marrow plasma cells <10% without CRAB criteria.

Documentation & Coding Risks

Avoid these common documentation and coding issues when documenting Myeloma to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code C90.00.

Impact

Clinical: Inaccurate treatment planning., Regulatory: Non-compliance with coding standards., Financial: Potential for denied claims.

Mitigation Strategy

Regularly update patient status in EHR., Ensure lab results are included in documentation.

Impact

Reimbursement: Incorrect coding may lead to denied claims., Compliance: Non-compliance with ICD-10 coding guidelines., Data Quality: Inaccurate clinical data representation.

Mitigation Strategy

Use D47.2 for MGUS/smoldering if no CRAB criteria are present.

Impact

Inadequate documentation of remission status can lead to audit issues.

Mitigation Strategy

Ensure all remission statuses are supported by lab results and clinical notes.

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 Myeloma, with expert answers to help guide accurate code selection and documentation.

Documentation Templates for Myeloma

Use these documentation templates to ensure complete and accurate documentation for Myeloma. These templates include all required elements for proper coding and billing.

Newly diagnosed multiple myeloma with renal failure

Specialty: Hematology

Required Elements

  • Patient history
  • Lab results
  • Imaging findings
  • Bone marrow biopsy results

Example Documentation

Diagnosed symptomatic multiple myeloma (C90.00) with serum free κ light chains 450 mg/L, 60% plasma cells on iliac crest biopsy, and CKD stage 3 (eGFR 45 mL/min/1.73m²).

Examples: Poor vs. Good Documentation

Poor Documentation Example
MM stable, continue chemo.
Good Documentation Example
MM in partial response (C90.01): Serum M-protein reduced from 2.1 to 0.7 g/dL, no new bone lesions. Tolerating lenalidomide without cytopenias.
Explanation
The good example provides specific lab results and treatment response details.

Need help with ICD-10 coding for Myeloma? Ask your questions below.

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