Multisystem inflammatory syndrome in children is referred to as MIS-C and the adult version is called MIS-A. The CDC describes MIS-C as a condition where “different body parts can become inflamed, including the heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal organs”.
Autoinflammatory syndrome, unspecified 1 M04.9 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. 2 The 2021 edition of ICD-10-CM M04.9 became effective on October 1, 2020. 3 This is the American ICD-10-CM version of M04.9 - other international versions of ICD-10 M04.9 may differ.
a positive test result for current or previous SARS-CoV-2 infection (nucleic acid, antigen, or antibody) during admission or in the previous 12 weeks, or exposure to person with COVID-19 within the 4 weeks prior to the onset of symptoms The new ICD-10 code for MIS (M35.81) includes “code first”, “code also”, and “use additional code” guidance:
Other inflammatory and immune myopathies, not elsewhere classified 1 Inflammatory disorder of muscle. 2 Myopathy due to disseminated lupus erythematosus. 3 Myopathy, inflammatory. 4 Myopathy, inflammatory paraneoplastic. 5 Myopathy, symptomatic inflammatory. 6 ... (more items)
Nationally, more than 1,200 cases of MIS and 23 deaths have been confirmed across 44 states, according to an ABC12 report published first week of January. Multisystem inflammatory syndrome in children is referred to as MIS-C and the adult version is called MIS-A.
As not much is known about MIS-C causes and risk factors, the condition is considered a syndrome – a group of signs and symptoms According to the CDC, cases met five criteria: 1 a severe illness requiring hospitalization in a person aged ≥21 years; 2 severe dysfunction of one or more extrapulmonary organ systems (e.g., hypotension or shock, cardiac dysfunction, arterial or venous thrombosis or thromboembolism, or acute liver injury) 3 laboratory evidence of severe inflammation 4 Fever ≥24 hours 5 a positive test result for current or previous SARS-CoV-2 infection (nucleic acid, antigen, or antibody) during admission or in the previous 12 weeks, or exposure to person with COVID-19 within the 4 weeks prior to the onset of symptoms
For individuals with MIS and COVID-19, assign code U07.1, COVID-19, as the principal/first-listed diagnosis and assign code M35.81 as an additional diagnosis.
Treatment. Hospitalization is required to treat MIS-C, with some patients needing treatment in a pediatric intensive care unit. Treatment usually involves supportive care and measures to reduce inflammation in affected organs and prevent permanent damage.
The new ICD-10 code for MIS (M35.81) includes “code first”, “code also”, and “use additional code” guidance:
Other types of care include treatment to reduce swelling and inflammation may include antibiotics, steroid therapy, intravenous immunoglobulin (IVIG), and therapies aimed at reducing high levels of cytokines or proteins which can cause inflammation.
Supportive care may include: fluids for dehydration, oxygen to address breathing issues, ventilator, blood pressure medications, medications that reduce the risk of blood clots, and rarely, the use of extracorporeal membrane oxygenation (ECMO). Other types of care include treatment to reduce swelling and inflammation may include antibiotics, steroid therapy, intravenous immunoglobulin (IVIG), and therapies aimed at reducing high levels of cytokines or proteins which can cause inflammation.
Aspirin has commonly been used due to concerns for coronary artery involvement, and antibiotics are routinely used to treat potential sepsis while awaiting bacterial cultures. Thrombotic prophylaxis is often used given the hypercoagulable state typically associated with MIS-C.
Patients with MIS-C usually present with persistent fever, abdominal pain, vomiting, diarrhea, skin rash, mucocutaneous lesions and, in severe cases, with hypotension and shock. They have elevated laboratory markers of inflammation (e.g., CRP, ferritin), and in a majority of patients laboratory markers of damage to the heart (e.g., troponin; B-type natriuretic peptide (BNP) or proBNP). Some patients develop myocarditis, cardiac dysfunction, and acute kidney injury. Not all children will have the same signs and symptoms, and some children may have symptoms not listed here. MIS-C may begin weeks after a child is infected with SARS-CoV-2. The child may have been infected from an asymptomatic contact and, in some cases, the child and their caregivers may not even know they had been infected.
Patients with a diagnosis of MIS-C should have close outpatient follow-up, including pediatric cardiology follow-up starting 2 to 3 weeks after discharge.
Testing aimed at identifying laboratory evidence of inflammation as listed in the Case Definition section is warranted.
Inflammation of a muscle or muscle tissue. Inflammation of skeletal muscle, not including inflammation of cardiac muscle. Inflammation of skeletal muscle. Myositis is inflammation of your skeletal muscles, which are also called the voluntary muscles.
The 2022 edition of ICD-10-CM G72.49 became effective on October 1, 2021.
The diseases dermatomyositis and polymyositis both involve myositis. Polymyositis causes muscle weakness, usually in the muscles closest to the trunk of your body. Dermatomyositis causes muscle weakness, plus a skin rash.
The 2022 edition of ICD-10-CM G72.4 became effective on October 1, 2021.
Inflammatory and immune myopathies, not elsewhere classified. G72.4 should not be used for reimbursement purposes as there are multiple codes below it that contain a greater level of detail. The 2021 edition of ICD-10-CM G72.4 became effective on October 1, 2020.