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ICD-10 Guide
ICD-10 CodesD47.2

D47.2

Billable

Monoclonal gammopathy

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/05/2025

Code Description

ICD-10 D47.2 is a billable code used to indicate a diagnosis of monoclonal gammopathy.

Key Diagnostic Point:

Monoclonal gammopathy refers to a condition characterized by the presence of an abnormal protein (monoclonal protein or M-protein) in the blood, produced by a clone of plasma cells. This condition is often detected incidentally during routine blood tests and can be associated with various underlying disorders, including multiple myeloma, Waldenström's macroglobulinemia, and other lymphoproliferative disorders. Monoclonal gammopathy is classified as a neoplasm of uncertain behavior, meaning that while it may not be immediately life-threatening, it has the potential to progress to more serious conditions. Surveillance is crucial, as some patients may develop complications or progress to malignancy over time. Regular monitoring of serum protein electrophoresis and immunofixation tests is recommended to assess changes in the monoclonal protein levels. The clinical management of monoclonal gammopathy involves a multidisciplinary approach, including hematology and oncology specialists, to determine the appropriate follow-up and intervention strategies based on individual risk factors and clinical presentation.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiation between benign and malignant forms of gammopathy
  • Need for ongoing surveillance and monitoring
  • Potential for progression to more serious conditions
  • Variability in clinical presentation and laboratory findings

Audit Risk Factors

  • Inadequate documentation of follow-up care
  • Failure to document the clinical rationale for surveillance
  • Misclassification of the condition as benign without proper evidence
  • Lack of detailed patient history and symptomatology

Specialty Focus

Medical Specialties

Hematology

Documentation Requirements

Detailed patient history, laboratory results, and follow-up plans.

Common Clinical Scenarios

Patients presenting with elevated protein levels, routine monitoring of known cases.

Billing Considerations

Ensure accurate documentation of any progression to malignancy or related conditions.

Oncology

Documentation Requirements

Comprehensive treatment plans, response to therapy, and any complications.

Common Clinical Scenarios

Management of patients with progression to multiple myeloma or other malignancies.

Billing Considerations

Document any treatment interventions and their outcomes.

Coding Guidelines

Inclusion Criteria

Use D47.2 When
  • According to ICD
  • 10 coding guidelines, D47
  • 2 should be used when documenting monoclonal gammopathy of uncertain behavior
  • It is important to include any relevant clinical findings and follow
  • up plans to support the diagnosis

Exclusion Criteria

Do NOT use D47.2 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

84155CPT Code

Immunofixation electrophoresis

Clinical Scenario

Used to confirm the presence of monoclonal protein in patients with suspected gammopathy.

Documentation Requirements

Document the indication for the test and any relevant clinical findings.

Specialty Considerations

Hematology specialists should ensure that the test results are correlated with clinical symptoms.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of monoclonal gammopathy, facilitating better tracking of patient outcomes and management strategies.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of monoclonal gammopathy, facilitating better tracking of patient outcomes and management strategies.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of monoclonal gammopathy, facilitating better tracking of patient outcomes and management strategies.

Resources

Clinical References

  • •
    American Society of Hematology

Coding & Billing References

  • •
    American Society of Hematology

Frequently Asked Questions

What is the difference between monoclonal gammopathy and multiple myeloma?

Monoclonal gammopathy is a condition characterized by the presence of abnormal proteins in the blood, which may or may not progress to multiple myeloma, a malignant condition. Diagnosis and management depend on clinical findings and laboratory results.