Neurology & Pain Management Coding Alert

ICD-10 to introduce separate fibromyalgia, myalgia, and myositis codes.

If your provider diagnoses a patient with fibromyalgia, your only code choice under ICD-9-CM is 729.1 (Myalgia and myositis, unspecified). That will change in October 2013 with the introduction of ICD-10 and three specific codes for those conditions:

• M60.9 -- Myositis, unspecified
• M79.1 -- Myalgia
• M79.7 -- Fibromyalgia.

These conditions are characterized by muscle or musculoskeletal pain and soft tissue or muscle tenderness. Symptoms of varying intensities increase and decrease over time.

• Myositis -- Inflammation of skeletal muscles ("myo" means muscles and "-itis" is the suffix for inflammation). Injury, infection, or an autoimmune disease can cause myositis.
• Myalgia -- Muscle pain ("myo" is the root for muscle and "-algia" is the suffix for pain). Myalgia is a symptom of many condition and diseases. Fibromyalgia -- Muscle and fibrous connective tissue pain ("fibro" is the base for fibrous tissue and "myalgia" is muscle pain).
• Fibromyalgia is characterized by long-term, body-wide pain and tenderness in the joints, muscles, tendons, and other soft tissues. Fatigue, sleep problems, headaches, depression, and anxiety have been linked to fibromyalgia.

ICD-10 change: Once ICD-10 goes into effect, providers will need to write more detailed notes than "muscle pain" or "muscle weakness." Having specific diagnoses for myositis, myalgia, and fibromyalgia will mean you need more details in order to code accurately. You'll want to include all three choices on your superbill when space allows, as a reminder for your provider to specify which condition the patient has.