ICD-10 Coding for Smoldering Myeloma(C90.00)
Complete ICD-10-CM coding and documentation guide for Smoldering Myeloma. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Smoldering Myeloma
C90.0-C90.02Primary Range
Multiple myeloma and malignant plasma cell neoplasms
Smoldering myeloma is classified under multiple myeloma codes, specifically C90.00 for cases not in remission.
Key Information: ICD-10 code for smoldering myeloma
Essential facts and insights about Smoldering Myeloma
Primary ICD-10-CM Code for smoldering myeloma
Decision Criteria
clinical Criteria
- Bone marrow plasma cells between 10-60% without CRAB symptoms.
documentation Criteria
- Explicit mention of 'smoldering multiple myeloma' in clinical notes.
Applicable To
- Smoldering myeloma
Excludes
- MGUS (D47.2)
- Active multiple myeloma with CRAB symptoms
Clinical Validation Requirements
- Bone marrow plasma cells 10-60%
- Serum M-protein ≥3 g/dL or urine M-protein ≥500 mg/24h
- Absence of CRAB features
Code-Specific Risks
- Confusion with MGUS or active myeloma
- Incorrectly coding as in remission
Coding Notes
- Ensure documentation specifies 'smoldering multiple myeloma' and meets all clinical criteria.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Personal history of other malignant neoplasms of lymphoid, hematopoietic tissues
Z85.79Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Monoclonal gammopathy of undetermined significance
D47.2Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Smoldering 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 misdiagnosis or inappropriate treatment., Regulatory: Non-compliance with documentation standards., Financial: Potential for denied claims due to insufficient documentation.
Mitigation Strategy
Use specific terms like 'smoldering multiple myeloma'., Ensure all clinical criteria are documented.
Impact
Reimbursement: Incorrect coding may lead to lower reimbursement., Compliance: Non-compliance with ICD-10 coding guidelines., Data Quality: Inaccurate clinical data affecting patient records.
Mitigation Strategy
Verify plasma cell percentage and M-protein levels to differentiate.
Impact
Using C90.01 for smoldering myeloma instead of C90.00.
Mitigation Strategy
Regular training on ICD-10 coding guidelines.
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 Myeloma, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Smoldering Myeloma
Use these documentation templates to ensure complete and accurate documentation for Smoldering Myeloma. These templates include all required elements for proper coding and billing.
Diagnosis of Smoldering Myeloma
Specialty: HematologyRequired Elements
- Bone marrow biopsy results
- Serum M-protein levels
- Absence of CRAB symptoms
- Imaging findings
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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