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2025 ICD-10-CM code C90.00

Multiple myeloma not having achieved remission.

Do not code bone metastasis (C79.51) separately when multiple myeloma involves bone, as bone involvement is inherent to the disease.

Medical necessity for treatments related to multiple myeloma is established by the confirmed diagnosis and the patient's specific clinical presentation, including disease stage, symptoms, and treatment response.

Diagnosis of multiple myeloma involves a combination of physical examination, review of medical history, blood tests (CBC, CRP, ESR), bone marrow biopsy, urine and kidney function tests, and imaging studies (CT, MRI, PET). Treatment options include observation for asymptomatic cases, autologous stem cell transplantation, localized radiation therapy, surgery, and chemotherapy regimens (single or multiple agents).

In simple words: This code is used when a person has multiple myeloma, a type of blood cancer affecting the plasma cells, and their treatment hasn't yet led to a state where the disease is controlled or inactive.Signs and symptoms may still be present.

This code describes multiple myeloma where the patient has not yet entered remission, meaning that signs and symptoms of the disease may still be present.

Example 1: A patient newly diagnosed with multiple myeloma is undergoing initial chemotherapy.As they have not yet achieved remission, C90.00 is used., A patient with a history of multiple myeloma had previously achieved remission, but now experiences recurrent symptoms after several months. Blood work and imaging confirm the disease's return.C90.00 is appropriate until remission is potentially re-established., A patient with multiple myeloma is undergoing continuous treatment, but the disease isn't fully controlled, and symptoms persist.C90.00 remains the correct code as long as they haven't achieved remission.

Documentation should include evidence from bone marrow biopsy, blood tests (CBC, CRP, ESR), imaging results (CT, MRI, PET scans), and clinical findings indicating the presence of multiple myeloma and the lack of remission status.

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