Find information on smoldering multiple myeloma diagnosis, including clinical documentation requirements, ICD-10 codes (C90.00, C90.01, C90.02), medical coding guidelines, and healthcare resources. Learn about diagnostic criteria, staging, and treatment considerations for smoldering myeloma. This resource provides essential information for healthcare professionals, including physicians, nurses, and medical coders involved in the management and documentation of smoldering multiple myeloma patients. Explore relevant medical terminology and best practices for accurate clinical documentation.
Also known as
Multiple myeloma
Malignant neoplasm of plasma cells, smoldering stage.
Monoclonal gammopathy
Abnormal protein in blood, can precede multiple myeloma.
Fever and other symptoms
May include symptoms related to smoldering myeloma like fatigue.
Follow this step-by-step guide to choose the correct ICD-10 code.
Is the diagnosis Smoldering Multiple Myeloma?
Yes
Is there evidence of end-organ damage?
No
Do not code as Smoldering Multiple Myeloma. Review documentation for alternative diagnosis.
When to use each related code
| Description |
|---|
| Smoldering Multiple Myeloma |
| MGUS |
| Active Multiple Myeloma |
Incorrectly coding as Monoclonal Gammopathy of Undetermined Significance (MGUS) due to overlapping symptoms, leading to underreporting severity.
Failure to document CRAB criteria (hypercalcemia, renal insufficiency, anemia, bone lesions) impacting accurate SMM diagnosis and coding.
Insufficient documentation of serum M-protein and or bone marrow plasma cells percentage, crucial for SMM diagnosis and differentiating from MGUS.
Patient presents with a diagnosis of smoldering multiple myeloma (SMM). This diagnosis is based on the International Myeloma Working Group (IMWG) criteria, demonstrating the presence of a serum monoclonal protein (M-protein) greater than or equal to 3 g/dL, andor bone marrow plasma cell infiltration between 10% and 59%, without evidence of myeloma-defining events or end-organ damage (CRAB criteria: hypercalcemia, renal insufficiency, anemia, or bone lesions). The patient does not exhibit symptoms related to the disease process, such as bone pain, fatigue, or recurrent infections. A complete blood count (CBC) and comprehensive metabolic panel (CMP) were performed, revealing normal kidney function, calcium levels within normal limits, and no significant anemia. Serum free light chain assay showed an abnormal kappa/lambda free light chain ratio. Skeletal survey and magnetic resonance imaging (MRI) of the spine and pelvis did not reveal any lytic lesions. Urine protein electrophoresis (UPEP) was performed to evaluate for Bence Jones protein. The patient's current presentation warrants close monitoring with scheduled follow-up appointments every three to six months including repeat serum protein electrophoresis (SPEP), UPEP, CBC, CMP, and serum free light chain assay. The patient has been educated on the significance of monitoring for disease progression and the potential need for future treatment if they develop symptomatic multiple myeloma. A discussion regarding clinical trials for smoldering myeloma was initiated. The patient understands the current management plan and the importance of reporting any new symptoms. ICD-10 code C90.00, monoclonal gammopathy of undetermined significance (MGUS), is used for coding purposes as there is no specific ICD-10 code for smoldering multiple myeloma. Appropriate medical billing codes will be used for the laboratory and imaging studies performed.