ICD-10 Coding for Plasma Cell Myeloma(C90.00, C90.01)
Complete ICD-10-CM coding and documentation guide for Plasma Cell Myeloma. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Plasma Cell Myeloma
C90.0-C90.3Primary Range
Multiple myeloma and malignant plasma cell neoplasms
This range includes codes for multiple myeloma, plasma cell leukemia, and plasmacytoma, which are primary conditions related to plasma cell myeloma.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| C90.00 | Multiple myeloma not having achieved remission | Use when the patient has active multiple myeloma without remission. |
|
| C90.01 | Multiple myeloma in remission | Use when the patient is in complete remission from multiple myeloma. |
|
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 plasma cell myeloma
Essential facts and insights about Plasma Cell Myeloma
Primary ICD-10-CM Codes for plasma cell myeloma
Decision Criteria
clinical Criteria
- Presence of ≥10% clonal plasma cells and CRAB features
Applicable To
- Active multiple myeloma
Excludes
- Monoclonal gammopathy of undetermined significance (MGUS) (D47.2)
Clinical Validation Requirements
- Bone marrow biopsy showing ≥10% clonal plasma cells
- Presence of CRAB features (hypercalcemia, renal insufficiency, anemia, bone lesions)
Code-Specific Risks
- Incorrectly coding remission status can lead to reimbursement issues.
Coding Notes
- Ensure documentation specifies the absence of remission.
C90.01 - Multiple myeloma in remission
Use when the patient is in complete remission from multiple myeloma.
Applicable To
- Multiple myeloma in complete remission
Excludes
- Active multiple myeloma (C90.00)
Clinical Validation Requirements
- Bone marrow biopsy showing <5% plasma cells
- Normal serum free light chain ratio
Coding Notes
Document remission status clearly with supporting lab results.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Plasma Cell 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: May lead to inappropriate treatment decisions., Regulatory: Non-compliance with coding guidelines., Financial: Potential for incorrect billing and reimbursement.
Mitigation Strategy
Ensure all documentation includes remission status.
Impact
Reimbursement: Incorrect coding can lead to reduced reimbursement., Compliance: Non-compliance with coding standards., Data Quality: Impacts the accuracy of clinical data.
Mitigation Strategy
Always document and code the specific remission status of the myeloma.
Impact
Inadequate documentation of remission status can lead to audit issues.
Mitigation Strategy
Implement standardized templates for documenting remission status.
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 Plasma Cell Myeloma, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Plasma Cell Myeloma
Use these documentation templates to ensure complete and accurate documentation for Plasma Cell Myeloma. These templates include all required elements for proper coding and billing.
New Diagnosis of Multiple Myeloma
Specialty: OncologyRequired Elements
- CRAB features
- Bone marrow biopsy results
- Serum protein electrophoresis
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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