C90.02

Billable

Multiple myeloma in relapse

HCC Category Mapping

V28HCC 19 — Lymphoma and Other Cancers

0.105

V24HCC 9 — Lung and Other Severe Cancers

0.973

ESRDHCC 9 — Lung and Other Severe Cancers

0.000

RxHCCHCC 16 — Multiple Myeloma and Plasma Cell Neoplasms

0.000

What This Code Means

Multiple myeloma that has returned or worsened after a period of remission or improvement.

Coding Tips

•Relapse (fifth character '2') indicates the cancer has returned after remission; distinguish from initial diagnosis
•Document the timeline of remission and relapse to support medical necessity for treatment decisions

Clinical Significance

Multiple myeloma in relapse indicates the disease has returned after a period of remission, with rising monoclonal protein levels, reappearance of bone marrow plasmacytosis, or recurrence of end-organ damage. Relapsed myeloma typically requires a change in treatment regimen, as the disease may have developed resistance to prior therapy. Each successive relapse generally portends a shorter subsequent remission duration.

Documentation Requirements

✓Documentation must include evidence of biochemical or clinical relapse based on IMWG criteria, such as rising monoclonal protein, new bone lesions, worsening anemia, or hypercalcemia.
✓The timeline from prior remission to relapse, prior treatment regimens, new treatment plan, and current disease burden must be documented.

Commonly Confused Codes

C90.00 (multiple myeloma not in remission) is for initial non-response to treatment, not relapse.C90.01 (multiple myeloma in remission) indicates response without recurrence.D47.2 (monoclonal gammopathy of undetermined significance) is a premalignant condition unrelated to relapse.

Code Hierarchy

└C90Multiple myeloma and malignant plasma cell neoplasms └C90.0Multiple myeloma └C90.02Multiple myeloma in relapse

└C90.02Multiple myeloma in relapse