ICD 10 Code for Fibromyalgia
Fibromyalgia is a chronic condition that causes widespread pain, fatigue, and other symptoms. It affects about 2% to 4% of the population, mostly women. Fibromyalgia is not a disease, but a syndrome, which means it is a collection of signs and symptoms that occur together.
What is the ICD 10 Code for Fibromyalgia?
The International Classification of Diseases, Tenth Revision, Clinical Modification (ICD 10 CM) is a system of codes that classify diseases and health problems for statistical and billing purposes. The ICD 10 CM code for fibromyalgia is M79.7.
The code M79.7 belongs to the category M79 (Other and unspecified soft tissue disorders, not elsewhere classified), which is part of the chapter M00-M99 (Diseases of the musculoskeletal system and connective tissue).
The code M79.7 is a billable/specific code that can be used to indicate a diagnosis for reimbursement purposes. The code M79.7 is valid during the fiscal year 2023 from October 01, 2022, through September 30, 2023, for the submission of HIPAA-covered transactions.
The code M79.7 is also applicable to fibromyositis, fibrositis, and myofibrositis, which are other names for fibromyalgia.
How to Use the ICD 10 Code for Fibromyalgia?
To use the ICD 10 code for fibromyalgia, you should follow these steps:
- Confirm the diagnosis of fibromyalgia by clinical criteria and tests. There is no specific test for fibromyalgia, but your doctor may use blood tests, imaging tests, or other methods to rule out other conditions that may cause similar symptoms. The most widely used criteria for fibromyalgia are the American College of Rheumatology (ACR) criteria, which require at least three months of widespread pain and tenderness in at least 11 out of 18 specific points on the body.
- Document the diagnosis of fibromyalgia in the medical record with supporting evidence and details. You should include information such as the onset, duration, frequency, intensity, and location of pain and other symptoms; the impact of fibromyalgia on your daily activities and quality of life; and any treatments or medications you are using or have tried for fibromyalgia.
- Assign the code M79.7 to the diagnosis of fibromyalgia in the claim form or electronic health record. You should use this code as the primary or principal diagnosis code if fibromyalgia is the main reason for your visit or encounter with your healthcare provider. You may also use other codes to report any coexisting conditions or complications related to fibromyalgia, such as depression, anxiety, insomnia, irritable bowel syndrome, or chronic fatigue syndrome.
- Check for any coding guidelines or rules that may affect the code assignment or reimbursement. For example, some payers may require additional documentation or authorization for certain services or procedures related to fibromyalgia. You should also be aware of any coding updates or changes that may occur over time.
- Review the code accuracy and completeness before submitting the claim or record. You should make sure that the code M79.7 reflects your current diagnosis and condition and that it matches the documentation in your medical record. You should also verify that you have followed all the coding rules and guidelines correctly.
Causes of Fibromyalgia:
The exact cause of fibromyalgia is unknown. However, several factors may contribute to its development, including genetics, physical or emotional trauma, infections, and abnormalities in the central nervous system.
Signs and Symptoms of Fibromyalgia:
- Widespread pain and tenderness throughout the body
- Fatigue and decreased energy levels
- Sleep disturbances and insomnia
- Cognitive difficulties (often referred to as “fibro fog“)
- Stiffness in muscles and joints
- Headaches and migraines
- Sensitivity to noise, light, and temperature
- Irritable bowel syndrome (IBS) and digestive issues
- Anxiety and depression
Diagnosis of Fibromyalgia:
There is no specific test to diagnose fibromyalgia. Diagnosis is typically based on a thorough medical history, physical examination, and assessment of symptoms. Doctors may also consider the presence of tender points and rule out other conditions with similar symptoms.
Treatment of Fibromyalgia:
- Medications: Certain medications may be prescribed to manage pain, improve sleep, and reduce symptoms associated with fibromyalgia. These can include pain relievers, antidepressants, and anti-seizure medications.
- Therapy: Cognitive-behavioral therapy (CBT) and other forms of counseling can help individuals cope with fibromyalgia symptoms, manage stress, and improve their overall well-being.
- Physical Therapy: Physical therapy and exercise programs tailored to the individual’s needs can help improve strength, and flexibility, and reduce pain.
- Lifestyle changes: Adopting a healthy lifestyle, including regular exercise, stress management techniques, good sleep habits, and a balanced diet, can be beneficial in managing fibromyalgia symptoms.
Prevention of Fibromyalgia:
Since the exact cause of fibromyalgia is unknown, there are no specific prevention methods. However, maintaining a healthy lifestyle, managing stress, and seeking prompt treatment for any injuries or illnesses that may trigger fibromyalgia symptoms can potentially reduce the risk or severity of the condition.
Conclusion
Fibromyalgia is a chronic condition that causes widespread pain, fatigue, and other symptoms. The ICD 10 code for fibromyalgia is M79.7, which is a billable/specific code that can be used to indicate a diagnosis for reimbursement purposes. To use the code correctly, you should confirm the diagnosis, document it properly, assign it accurately, and review it thoroughly.
References
(1) M79.7 – Fibromyalgia – ICD List 2023.
(2) 2023 ICD-10-CM Diagnosis Code M79.7: Fibromyalgia.
(3) 2023 ICD-10-CM Diagnosis Code G90.50 – The Web’s Free 2023 ICD-10-CM ….
(4) What is the ICD 10 Code for Fibromyalgia? – Native Formulas.
FAQs
What is the ICD-10 code for Fibromyalgia?
The ICD-10 code for Fibromyalgia is M79.7.
Can you provide the specific code for Fibromyalgia in ICD-10?
The specific code for Fibromyalgia in ICD-10 is M79.7.
How does the ICD-10 classify Fibromyalgia?
Fibromyalgia is classified as a musculoskeletal pain disorder in the ICD-10 system.
What are the key diagnostic criteria for assigning the ICD-10 code for Fibromyalgia?
The key diagnostic criteria for assigning the ICD-10 code for Fibromyalgia include widespread pain and tenderness in specific body regions.
Has Fibromyalgia considered a chronic pain disorder in ICD-10?
Yes, Fibromyalgia is considered a chronic pain disorder in the ICD-10 system.
Are there any subcategories or subcodes for Fibromyalgia in ICD-10?
There are no subcategories or subcodes specifically for Fibromyalgia in ICD-10.
Can you explain the coding guidelines for Fibromyalgia in ICD-10?
The coding guidelines for Fibromyalgia in ICD-10 recommend documenting the specific body regions affected by pain and tenderness.
Are there any additional documentation requirements for assigning the ICD-10 code for Fibromyalgia?
There are no additional documentation requirements for assigning the ICD-10 code for Fibromyalgia.
Are there any commonly associated conditions or comorbidities included in the ICD-10 code for Fibromyalgia?
There are no commonly associated conditions or comorbidities included in the ICD-10 code for Fibromyalgia.
What are the limitations or challenges associated with coding Fibromyalgia using the ICD-10 system?
Coding Fibromyalgia using the ICD-10 system may have limitations and challenges, such as subjective symptom reporting and potential overlap with other conditions.