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Home/Diagnosis/ICD-10 Coding for Fibromyalgia

ICD-10 Coding for Fibromyalgia

M79.7
G89.4

Complete ICD-10-CM coding and documentation guide for icd-10 coding for fibromyalgia includes clinical validation requirements, medical necessity guidelines, and coding policies.

Also Known as:
Fibrositis
Fibromyositis
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Key Information: ICD-10 Coding for Fibromyalgia

Essential facts and insights about ICD-10 Coding for Fibromyalgia

Use ICD-10 code M79.7 for fibromyalgia, ensuring proper documentation in clinical notes.

Primary ICD-10-CM Codes

Fibromyalgia

Billable Code
M79.7
Billable

Diagnostic Criteria

clinical:
  • • Patient meets 2010 ACR criteria with documented WPI and SS scores.
coding:
  • • Use M79.7 when fibromyalgia is the primary diagnosis and not specifically for pain management.
documentation:
  • • Include exclusion of other rheumatic diseases in the documentation.

Applicable To

  • • Fibrositis
  • • Fibromyositis

Important Notes

  • • Ensure documentation includes WPI and SS scores, duration of symptoms, and exclusion of other conditions.

Chronic pain syndrome

Billable Code
G89.4
Billable

Diagnostic Criteria

clinical:
  • • Pain management is the primary reason for the encounter

Important Notes

  • • Ensure proper sequencing with M79.7 when pain management is the focus.
Ancillary Codes

Additional codes that may be used with this diagnosis

F32.9

Depression, unspecified

Use when depression is a comorbid condition affecting the patient's care.

Frequently Asked Questions

What is the ICD-10 code for fibromyalgia?

The ICD-10 code for fibromyalgia is M79.7, used for most clinical encounters unless the visit is specifically for pain management.

When should G89.4 be used with fibromyalgia?

Use G89.4 when the primary purpose of the visit is pain management, such as opioid management or nerve blocks.

What documentation is required for fibromyalgia coding?

Documentation must include WPI and SS scores, symptom duration, and exclusion of other conditions to support the fibromyalgia diagnosis.

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