ICD-10 code M79. 1 for Myalgia is a medical classification as listed by WHO under the range - Soft tissue disorders .
ICD-10 code M54. 5, low back pain, effective October 1, 2021. That means providers cannot use M54.
The current code, M54. 5 (Low back pain), will be expanded into three more specific codes: M54. 50 (Low back pain, unspecified)
The 2022 edition of ICD-10-CM M79. 1 became effective on October 1, 2021. This is the American ICD-10-CM version of M79. 1 - other international versions of ICD-10 M79.
2022 ICD-10-CM Diagnosis Code M54. 5: Low back pain.
9: Dorsalgia, unspecified.
The new diagnosis code – M54. 51 – went into effect on October 1, 2021. This code will be applied to patients meeting indications for treatment with basivertebral nerve radiofrequency neurotomy. Help sustain this vital advocacy with your donations.
Code M54. 5 is the diagnosis code used for Low Back Pain (LBP). This is sometimes referred to as lumbago.
Myalgia describes muscle aches and pain, which can involve ligaments, tendons and fascia, the soft tissues that connect muscles, bones and organs. Injuries, trauma, overuse, tension, certain drugs and illnesses can all bring about myalgia.
Unspecified symptoms and signs involving the musculoskeletal system. R29. 91 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.
Myalgia traumatic should be coded to “ other injury of unspecified body region” Dx T14.8XXA, T14.8XXD or T14.8XXS
Different types of blood tests, radiology tests (X-Ray, MRI, CT), nerve conduction studies etc are used to find out the underlying condition.
Polymyalgia – This leads to ICD M35.3 which is an inflammatory disease of muscle (Polymyalgia Rheumatica).
Sometimes pain happens only for a short period of time and some other time pain lasts for months or years. Myalgia is not a disease instead symptom of another problem. Reasons for muscle pain may be stress, minor injury, overuse, side effect of medication, infection or inflammation or any other disease.
Keep in mind that myalgia is a symptom, hence follow ICD coding guideline of not coding signs and symptoms when there is a definitive diagnosis.
Acute or chronic pain in the lumbar or sacral regions, which may be associated with musculo-ligamentous sprains and strains; intervertebral disk displacement; and other conditions.
M54.5 should not be used for reimbursement purposes as there are multiple codes below it that contain a greater level of detail.
M79.1 is a non-billable ICD-10 code for Myalgia. It should not be used for HIPAA-covered transactions as a more specific code is available to choose from below.
DO NOT include the decimal point when electronically filing claims as it may be rejected. Some clearinghouses may remove it for you but to avoid having a rejected claim due to an invalid ICD-10 code, do not include the decimal point when submitting claims electronically.