ICD-10 Coding for Smoldering Multiple Myeloma(C90.00)
Complete ICD-10-CM coding and documentation guide for Smoldering Multiple Myeloma. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Smoldering Multiple Myeloma
C90.0-C90.02Primary Range
Multiple myeloma and malignant plasma cell neoplasms
This range includes codes for multiple myeloma, with C90.00 specifically for smoldering multiple myeloma.
Key Information: ICD-10 code for smoldering multiple myeloma
Essential facts and insights about Smoldering Multiple Myeloma
Primary ICD-10-CM Code for smoldering multiple myeloma
Decision Criteria
clinical Criteria
- Patient has serum M-protein ≥3 g/dL and 10-60% clonal plasma cells without CRAB symptoms.
documentation Criteria
- Absence of CRAB symptoms must be documented explicitly.
Applicable To
- Smoldering multiple myeloma
Clinical Validation Requirements
- Serum M-protein ≥3 g/dL
- 10-60% clonal plasma cells in bone marrow
- Absence of CRAB symptoms
Code-Specific Risks
- Misclassification as active multiple myeloma if CRAB symptoms are present.
Coding Notes
- Ensure documentation specifies the absence of CRAB symptoms and includes 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.
Multiple myeloma with CRAB symptoms
C90.02Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Smoldering Multiple 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: Misdiagnosis risk due to lack of specificity., Regulatory: Potential audit failure due to incomplete documentation., Financial: Denial of claims due to insufficient documentation.
Mitigation Strategy
Use structured templates for documentation., Ensure all lab and imaging results are included.
Impact
Reimbursement: Incorrect DRG assignment leading to potential overpayment., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data affecting patient records.
Mitigation Strategy
Verify absence of CRAB symptoms before coding as SMM.
Impact
Coding SMM as active MM without CRAB symptoms leads to audit risks.
Mitigation Strategy
Implement thorough documentation checks for CRAB symptoms.
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 Smoldering Multiple Myeloma, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Smoldering Multiple Myeloma
Use these documentation templates to ensure complete and accurate documentation for Smoldering Multiple Myeloma. These templates include all required elements for proper coding and billing.
Initial Diagnosis of SMM
Specialty: HematologyRequired Elements
- Serum M-protein level
- Bone marrow plasma cell percentage
- Absence of CRAB symptoms
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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