ICD-10 Coding for Waldenström Macroglobulinemia(C88.0, C88.00, C88.01)
Complete ICD-10-CM coding and documentation guide for Waldenström Macroglobulinemia. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Waldenström Macroglobulinemia
C88.0-C88.9Primary Range
Malignant immunoproliferative diseases
This range includes codes for Waldenström macroglobulinemia and related conditions.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| C88.0 | Waldenström macroglobulinemia | Use as a base code for WM diagnosis, specify remission status with C88.00 or C88.01. |
|
| C88.00 | Waldenström macroglobulinemia not in remission | Use when WM is active and not in remission. |
|
| C88.01 | Waldenström macroglobulinemia in remission | Use when WM is in remission. |
|
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 Waldenström macroglobulinemia
Essential facts and insights about Waldenström Macroglobulinemia
Primary ICD-10-CM Codes for waldenstrom macroglobulinemia
Decision Criteria
clinical Criteria
- Presence of MYD88 L265P mutation
coding Criteria
- Use C88.00 for active disease, C88.01 for remission
documentation Criteria
- Document bone marrow biopsy and serum IgM levels
Applicable To
- IgM monoclonal gammopathy
- ≥10% bone marrow lymphoplasmacytic infiltration
Clinical Validation Requirements
- Bone marrow biopsy showing ≥10% lymphoplasmacytic infiltration
- Serum IgM monoclonal protein level
- MYD88 L265P mutation
Code-Specific Risks
- Incorrect use without specifying remission status
- Confusion with other lymphomas
Coding Notes
- Ensure remission status is documented and coded appropriately.
C88.00 - Waldenström macroglobulinemia not in remission
Use when WM is active and not in remission.
Applicable To
- Active disease with symptoms
Clinical Validation Requirements
- Hemoglobin <10 g/dL
- Platelets <100k/µL
- Constitutional symptoms
Coding Notes
Ensure active disease status is clearly documented.
C88.01 - Waldenström macroglobulinemia in remission
Use when WM is in remission.
Applicable To
- Documented complete hematologic response
Clinical Validation Requirements
- Bone marrow biopsy confirmation
- IgM reduction by ≥50%
Coding Notes
Document remission status with supporting lab results.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Waldenström Macroglobulinemia to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code C88.0.
Impact
Clinical: Inaccurate treatment planning., Regulatory: Non-compliance with coding standards., Financial: Potential claim denials.
Mitigation Strategy
Verify remission status before coding.
Impact
Reimbursement: Incorrect coding can lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate patient records.
Mitigation Strategy
Always specify remission status with C88.00 or C88.01.
Impact
Failure to document remission status can lead to audit issues.
Mitigation Strategy
Implement checklist for remission documentation.
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 Waldenström Macroglobulinemia, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Waldenström Macroglobulinemia
Use these documentation templates to ensure complete and accurate documentation for Waldenström Macroglobulinemia. These templates include all required elements for proper coding and billing.
Oncology Progress Note
Specialty: OncologyRequired Elements
- Assessment of WM status
- Documentation of symptoms
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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