2025 ICD-10-CM code R80.3
Bence Jones proteinuria is the presence of Bence Jones protein in the urine, indicating a possible multiple myeloma or other plasma cell dyscrasia.
No modifiers are typically applicable to R80.3, as it represents a finding and not a procedure.
Medical necessity for coding R80.3 is established by the presence of clinical findings suggestive of multiple myeloma or other plasma cell disorders, supported by laboratory evidence of Bence Jones proteinuria. Further diagnostic testing is generally required to confirm the specific diagnosis.
The clinical responsibility for diagnosing and managing Bence Jones proteinuria involves a hematologist or oncologist.The primary care physician may order initial urinalysis and refer the patient for specialized testing and treatment.
- Chapter 17: Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99)
- R80-R82: Abnormal findings on examination of urine, without diagnosis
In simple words: Bence Jones proteinuria means that an abnormal protein is found in the urine. This often indicates a type of blood cancer called multiple myeloma, which affects bone marrow.Further tests are needed to confirm the diagnosis.
Bence Jones proteinuria is characterized by the excretion of monoclonal immunoglobulin light chains (Bence Jones proteins) in the urine.These proteins are fragments of immunoglobulin light chains produced by malignant plasma cells.Their presence is a significant indicator of multiple myeloma, a cancer of plasma cells in the bone marrow.Other plasma cell dyscrasias, such as Waldenström's macroglobulinemia, may also cause Bence Jones proteinuria. The diagnosis requires further investigation beyond the presence of Bence Jones protein in urine, including serum protein electrophoresis, immunofixation, and bone marrow biopsy.
Example 1: A 65-year-old male presents with fatigue, bone pain, and recurrent infections.Urinalysis reveals Bence Jones proteinuria.Further workup confirms multiple myeloma., A 70-year-old female with a history of monoclonal gammopathy of undetermined significance (MGUS) undergoes routine bloodwork which reveals an increase in serum monoclonal protein and a positive urine Bence Jones protein test, confirming progression to multiple myeloma., A 58-year-old patient with suspected Waldenström's macroglobulinemia undergoes testing that reveals the presence of Bence Jones protein in urine supporting the suspected diagnosis. This leads to additional investigation for confirmation.
** R80.3 is typically a provisional diagnosis pending further investigations.Once a definitive diagnosis is established (e.g., multiple myeloma, Waldenström's macroglobulinemia), that diagnosis should be coded instead. The use of this code should be accompanied by proper documentation supporting the clinical indications and necessity for testing to confirm a diagnosis.
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Specialties:Hematology, Oncology, Nephrology
- Place of Service:Office, Hospital (inpatient or outpatient), Laboratory