C90.02 ICD-10-CM Code: Multiple myeloma in relapse
HCC Buddy Code Card
Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.
FY 2026 Apr update / Neoplasms (C00-D49) / Malignant neoplasms of lymphoid, hematopoietic and related tissue (C81-C96)
C90.02
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceMultiple myeloma in relapse
Multiple myeloma that has returned or worsened after a period of remission or improvement.
Buddy Insight
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.
CMS-HCC V28
MappedHCC 19
RAF 0.105
CMS-HCC V24
MappedHCC 9
RAF 0.973
ACA/HHS
00
RAF 0
ESRD/PACE
MappedHCC 9
RAF 0.0
RXHCC
MappedHCC 16
RAF 0.0
Code Trumping
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Code Book Path
Inclusion Terms
Official- Kahler's disease
- Medullary plasmacytoma
- Myelomatosis
- Plasma cell myeloma
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for C90.02 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for C90.02 in this effective period.
Excludes 1
Official- solitary myeloma (C90.3-)
- solitary plasmactyoma (C90.3-)
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for C90.02 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for C90.02 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for C90.02 in this effective period.
Buddy Documentation Tip
MEAT Support
Audit Caution
Common Mistakes
Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.
Is C90.02 an HCC code?
Yes. C90.02 maps to Lymphoma and Other Cancers under the CMS-HCC V28 risk adjustment model (and Lung and Other Severe Cancers under V24).
HCC Category Mapping
RAF weights shown are the community, non-dual, aged base weights from the CMS risk adjustment model file. Actual per-patient RAF contribution depends on member segment, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains in use during the transition and for historical data.
MEAT Criteria for C90.02
For C90.02to count as a valid HCC diagnosis in a given encounter, the provider's documentation must show MEAT: Monitor, Evaluate, Assess, or Treat. A diagnosis from a prior year does not carry forward automatically, it has to be re-documented and supported each calendar year.
- MMonitor: signs, symptoms, disease progression, or lab trending documented in the note
- EEvaluate: test results, medication response, or physical findings reviewed by the provider
- AAssess: explicit mention in the assessment or plan with acknowledgment of status
- TTreat: medication, referral, procedure, therapy, or counseling tied to the diagnosis
Only one of M/E/A/T is required to support the code, but the documentation must be specific enough to show that the provider actually addressed C90.02 during that encounter, not just copy-forwarded from a problem list.
What This Code Means
C90.02 is the ICD-10-CM diagnosis code for multiple myeloma in relapse. Multiple myeloma that has returned or worsened after a period of remission or improvement. C90.02 sits in the ICD-10-CM chapter for neoplasms (c00-d49), within the section covering malignant neoplasms of lymphoid, hematopoietic and related tissue (c81-c96).
Under the CMS-HCC V28 risk adjustment model, C90.02 maps to Lymphoma and Other Cancers (HCC 19) with a community, non-dual, aged base RAF weight of 0.105. Under the older CMS-HCC V24 model, C90.02 maps to Lung and Other Severe Cancers (HCC 9) with a community, non-dual, aged base RAF weight of 0.973. V28 is the CMS-HCC risk adjustment model that reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition.
Relapse (fifth character '2') indicates the cancer has returned after remission; distinguish from initial diagnosis. Because C90.02 maps to a payment HCC, the provider's documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's Medicare Advantage risk adjustment score. When documentation is ambiguous, coders should issue a provider query rather than assume the highest-specificity variant.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for C90.02 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
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.