Oncology & Hematology Coding Alert

Look for a one-to-one match for all codes.

ICD-9-CM offers simple coding options for multiple myeloma. Keep your focus on remissions and relapses to make your way to the right code. Here is a quick walkthrough of the direct matching codes in ICD-10-CM.

Check for Remission or Relapse

When reporting multiple myeloma in ICD-9-CM, you choose diagnosis codes depending upon whether or not your hematologist has documented remission for the patient. You report code 203.00 (Multiple myeloma, without mention of having achieved remission) when your clinician either does not report a remission for the patient in the clinical notes or documents that the patient has not yet attained a remission. The corresponding ICD-10-CM code is C90.00 (Multiple myeloma not having achieved remission).

If, however, you have documentation in support of remission, you report ICD-9-CM code 203.01 (Multiple myeloma in remission). Like 203.00, there is a matching ICD-10-CM code for 203.01; you report ICD-10-CM code C90.01 (Multiple myeloma in remission).

When your hematologist documents a relapse in multiple myeloma, you report ICD-9-CM code 203.03 (Multiple myeloma, in relapse) and the corresponding code C90.02 (Multiple myeloma in relapse) in ICD-10-CM.

Documentation: There isn’t an additional documentation requirement for reporting multiple myeloma in ICD-10-CM. The documentation you need remains the same as in ICD-9-CM; i.e., you need to ensure your hematologist records in the clinical records if the patient attained a remission or went into a relapse later.

Coder tips: Look for a direct one-to-one match for the diagnosis codes for multiple myeloma.

Note: You do not report the 203.0x codes for solitary myeloma which has a specific ICD-9-CM code, 238.6 (Neoplasm of uncertain behavior of plasma cells). The corresponding ICD-10-CM code for a solitary myeloma is D47.Z9 (Other specified neoplasms of uncertain behavior of lymphoid, hematopoietic and related tissue).

Remember: CMS has finalized the ICD-10-CM compliance date of Oct. 1, 2014. When ICD-10-CM goes into effect, you should apply the code set and official guidelines in effect for the date of service reported. Learn more at www.cms.gov/ICD10/ and www.cdc.gov/nchs/icd/icd10cm.htm#10update.