Data Last Updated: Dec. 17, 2025

Serum Albumin Pretreatment Level

Description

Albumin is the most abundant protein in human blood plasma. Serum albumin pretreatment level is a prognostic factor for plasma cell myeloma. The Revised International Staging System (R-ISS or RISS) is now used to stage plasma cell myeloma (9732/3), using several different criteria. The stages are based on the absence or presence of the following related criteria. * 3931: Serum Beta-2 Microglobulin Pretreatment Level * 3930: Serum Albumin Pretreatment Level * 3857: High Risk Cytogenetics * 3869: LDH Level Required for Staging: The AJCC Staging System Plasma Cell Myeloma and Plasma Cell Disorders (9732/3 only) and EOD. * Note: R-ISS stage is not applicable for the descriptions of plasma multiple myeloma that are listed in the codes 1 and 9 in the SSDI Schema Discriminator 1: Plasma Cell Myeloma Terminology. If you have coded 1 or 9 for this Schema Discriminator, the four data items listed above are BLANK. The R-ISS stages are * Stage I: Serum Beta-2-microglobulin <3.5 mg/L and serum albumin > 3.5 g/dL and no high-risk cytogenetics and Normal LDH * Stage II: Not R-ISS I or III * Stage III: Serum Beta-2-microglobulin > 5.5 mg/L and high-risk cytogenetics and/or high LDH

Rationale

Serum albumin pretreatment level is a prognostic factor required in AJCC 8th edition, Chapter 82 Plasma Cell Myeloma and Plasma Cell Disorders, for the Revised International Staging System (R-ISS). It is a new data item for cases diagnosed 1/1/2018+.

Additional Info

**Source documents:** laboratory tests (blood only) * Albumin Blood Test * Preoperative Blood Work * Total Protein and Albumin/Globulin (A/G) Ratio Test * Comprehensive metabolic profile (CMP) * Liver Function Test (LFT)/Hepatic Panel * Nutritional assessment Panels * Renal Function Panel

Notes

**Note 1:** **Physician statement** * Physician statement of Serum Albumin Pretreatment Level can be used to code this data item when no other information is available. **Note 2:** **Pretreatment results only** * Record this data item based on a **blood test** performed at diagnosis (pre-treatment). Use the highest value available. * The actual test may not state serum; however, as long as the test results are **based on blood (includes plasma)**, they can be used. * Albumin results from a **urine test cannot be used** to code this data item. * To use the albumin test, **it must say "Serum/Plasma/Blood."** **Note 3:** **Component of R-ISS Stage** * Serum albumin is part of the Revised International Staging (R-ISS). * A lab value expressed in grams per liter (g/L) is 10 times the same value expressed in g/dL; therefore, the cut point of 3.5 g/dL is equivalent to 35 g/L. * Elevated serum albumin is defined by ≥3.5 g/dL. * Use the cut points listed in the table below regardless of the lab’s reference range. * **Code 1** if physician states **RISS Stage 1** and there is no other information

Coding Guidelines

**1) Code 5** if Schema Discriminator 1: Plasma Cell Myeloma Terminology is coded to 1 or 9 **2) Code 9** when there is no mention of the serum albumin
Code Description
0 Serum albumin <3.5 g/dL
1 Serum albumin ≥3.5 g/dL
5 Schema Discriminator 1: Plasma Cell Myeloma Terminology coded to 1 or 9
7 Test ordered, results not in chart
9 Not documented in medical record
Serum Albumin not assessed or unknown if assessed