Division Chief: David Siegal, MD
Quality Indicators:
- New patients have a beta 2 microglobulin level evaluated.
- Patients with multiple myeloma who have lytic destruction of the bone or compression fracture of the spine from osteopenia receive bisphosphonate therapy.
All Patients
- All patients with solid tumors are staged according to ACoS standards.
- All patients who are receiving chemotherapy have a plan documented prior to administration of therapy.
Diagnostic Work Up:
Multiple Myeloma
| ICD 9 Codes |
|
203.00
|
|
203.01
|
| 203.02 |
| 203.10 |
| 203.11 |
| 203.12 |
|
203.80
|
|
203.81
|
| 203.82 |
|
238.60
|
|
| Diagnostic Work Up |
| Test/Exam: |
|
History and Physical Examination
|
|
Complete metabolic panel
|
|
LDH (Lactate dehydrogenase)
|
|
Phosphorus
|
|
Uric Acid
|
|
GGT (Gamma-glutamyltransferase)
|
|
Magnesium
|
|
B2 microglobulin
|
|
Quantitative IgG, IgA, IgM serum
|
|
Serum protein electropheresis
|
|
Serum immunofixation
|
|
Serum Free Kappa/Lambda light chain
|
|
24 hour urine specimen sent for total protein, total creatinine, creatinine clearance, urine protein electropheresis, urine immunofixation
|
|
Skeletal survey bilateral ribs, tibia & fibula
|
|
Bone density study
|
|
Tissue doppler echocardiogram
|
|
MRI cervical, thoracic, lumbar spine without contrast
|
|
MRI brain without contrast
|
|
MRI pelvis without contrast
|
|
PET/CT scan head to toe for Plasmacytoma
|
|
Bone marrow biopsy
|
|
Specimen sent for cytogenetics, FISH, gene expression profile, tissue preservation, and flow cytometry
|
|
Abdominal fat pad aspiration biopsy if Amyloidosis is suspected
|
|
|
