Treatment of multiple myeloma with bisphosphonates (Measure 69)

If patient has multiple myeloma (ICD-9 diagnosis code: 203.00

AND CPT E/M service codes: 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 99241, 99242, 99243, 99244 and 99245) and has bone disease, including osteopenia recommend intravenous bisphosphonates monthly. Bisphosphonates can inhibit bone resorption by reducing the number and activity of osteoclasts and therefore could reduce pain and bone fractures in people with multiple myeloma.

DESCRIPTION: Percentage of patients aged 18 years and older with a diagnosis of multiple myeloma, not in remission, who were prescribed or received intravenous bisphosphonate therapy within 12 months GUIDELINE If patient has multiple myeloma and has bone disease, including osteopenia recommend intravenous bisphosphonates monthly. Multiple myeloma is a disease characterized by bone destruction, in the form of diffuse osteopenia and/or osteolytic lesions, which develop in 85% of patients. Bisphosphonates can inhibit bone resorption by reducing the number and activity of osteoclasts and therefore could reduce pain and bone fractures in people with multiple myeloma

Reference:

• Kyle RA, Yee GC, Somerfield MR, Flynn PJ, Halabi S, Jagannath S, Orlowski RZ, Roodman DG, Twilde P, Anderson K. American Society of Clinical Oncology 2007 clinical practice guideline update on the role of bisphosphonates in multiple myeloma. J Clin Oncol 2007 Jun 10;25(17):2464-72.
• Smith A, Wisloff F, Samson D, UK Myeloma Forum, Nordic Myeloma Study Group, British Committee for Standards in Haematology. Guidelines on the diagnosis and management of multiple myeloma 2005. Br J Haematol 2006 Feb; 132(4):410-51.
• NCCN Clinical practice guidelines in oncology. Multiple myeloma. V.1.2008

http://www.nccn.org/professionals/physician_gls/PDF/myeloma.pdf