Radiology Coding Alert

Question: I’ve had a few reports come across my workflow where the physician lists the diagnoses as “greater trochanteric pain syndrome” or “myofascial pain syndrome.”

Should I just report these types of diagnoses with the corresponding pain codes?

Nevada Subscriber

Answer: Yes, you will use corresponding pain codes for those diagnoses. For the myofascial pain syndrome diagnosis, you’ll assign M79.18 (Myalgia, other site) to report the condition. You’ll then assign one of the following codes to report the greater trochanteric pain syndrome, depending on which side of the body is affected:

• M25.551 (Pain in right hip)
• M25.552 (Pain in left hip)
• M25.559 (Pain in unspecified hip)

If we examine the myofascial pain syndrome diagnosis as an example, you’ll find different paths to arrive at the correct code. When you look up Syndrome > pain in the ICD-10-CM Alphabetic Index, you’re redirected to Pain. Under Pain, you’ll find myofascial M79.18, which you can verify in the Tabular List. Simultaneously, If you return to Syndrome > myofascial pain, you’ll also find M79.18.

In the Tabular List, M79.18 is listed with a descriptor of “Myalgia, other site.” One code level up at M79.1- (Myalgia) features an additional condition of “Myofascial pain syndrome,” which means that the codes in the M79.1- subcategory will suffice for a myofascial pain syndrome diagnosis.