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Now There’s a Diagnosis! What You Need to Know About the Fibromyalgia ICD 10 Code

A lady holding her head in pain

When you are living with a disease as painful and complicated as fibromyalgia, it can be incredibly frustrating to get a real diagnosis for your problem.

But finally, there’s some help!

For years, patients who are experiencing the symptoms of this debilitating disease just had to suffer in silence.

From chronic widespread pain to constant fatigue, anxiety, and dozens of other symptoms, fibromyalgia wreaks havoc on a person’s musculoskeletal system as well as creating cognitive dysfunction, sleep disturbances, and emotional and mental issues.

Basically, fibromyalgia is a terror for many people who have to live with it every day.

But now, thanks to some much-needed governmental regulations, there is now hope for millions of people who are living with these symptoms.

A person in pain

The ICD has created a fibromyalgia ICD 10 code for people who present with the symptoms of chronic fatigue syndrome, and healthcare providers can treat it more effectively.

This is revolutionary news for so many fibromyalgia sufferers!

Let’s talk about what exactly is an ICD 10 code, why it’s so hard to get healthcare providers to use it for a fibromyalgia diagnosis, and what you can do to encourage your healthcare provider to use it appropriately.

Fibromyalgia and all the symptoms that come with it are not something you should have to continue to suffer from. It’s time for some hope.

What Exactly Is an ICD 10 Code?

For more than a century, the world health assembly and its partners have used a system for diagnosing diseases that are recognized worldwide by healthcare teams and medical professionals everywhere.

ICD stands for International Classification of Diseases and is the global standard for medical diagnosis in every part of the world.

Different variants of the classifications are introduced periodically. The next standard for medical diagnosis will be the ICD 11.

Each disease that is given an ICD code means it is now recognized worldwide as a legitimate human disease.

Once diseases have their own ICD code, hospitals and medical offices can submit payment to insurance companies to compensate them for appointments and fibromyalgia medication, since the condition they are treating for is deemed “medically legitimate.”

Clearly, this is great news for fibromyalgia sufferers.

For years, those experiencing the symptoms of chronic fatigue symptom were told that their ailments were either because of other undiagnosed or unspecified soft tissue disorders or that perhaps they just needed to get more exercise.

Chronic fatigue syndrome was also thought to be something that was just “in a patient’s head.”

A healthcare provider

But now, thanks to the fact that there is now a legitimate ICD code for fibromyalgia, we should begin to see changes in the way that medical professionals begin treating the symptoms of this painful and complicated disease.

Why Is It So Hard to Get Health Care Providers to Use the Fibromyalgia ICD 10 Code?

Even though there is now an actual code for diagnosing fibromyalgia, that doesn’t mean that healthcare professionals are always willing to use it.

The reasons for this are varied and extremely frustrating for patients.

Like many soft tissue disorders, fibromyalgia presents in different ways for different individuals.

Though almost every fibromyalgia sufferer will deal with chronic widespread pain and levels of cognitive dysfunction, the way that these symptoms present can be varied for each person.

For example, many people with fibromyalgia will tell their physician or other healthcare provider that they are experiencing muscle pain in their legs and feet.

Others may complain of soft tissue disorders occurring in their lower back, shoulders, or neck region.

Trying to determine where a person’s soft tissue disorders are originating can be extremely challenging for medical professionals, since there is no way to x-ray or even run a diagnostic test on the deeper muscles and connective tissue areas in a patient’s body.

Like many soft tissue disorders, fibromyalgia presents in different ways for different individuals.

Another complication with diagnosing fibromyalgia is that oftentimes a physician needs to rule out other possible musculoskeletal system and connective tissue disorders in order to make sure the chronic pain and other symptoms a patient is experiencing are not the result of something else.

There are several autoimmune disorders that have many of the same symptoms that fibromyalgia does, and it is easy to misdiagnose one for the other if care isn’t taken to rule out other possibilities.

Those who suffer from rheumatism will also complain of constant fatigue, muscle pain, other types of soft tissue pain, and other general symptoms that are also associated with fibromyalgia.

Another autoimmune disorder that can look like fibromyalgia is multiple sclerosis.

Multiple sclerosis (MS for short) is an autoimmune disorder that tends to manifest as muscle pain, cognitive dysfunction, problems with balance, and emotional issues…many of the same conditions that affect a person who has fibromyalgia.

It becomes easy to understand why getting a fibromyalgia diagnosis can start to become complicated – and extremely frustrating for the more than 4 million Americans that are suffering from it!

That said, one option for healthcare providers is to test a patient for these other soft tissue disorders in order to rule out them out as possible reasons for a patient’s symptoms.

Though there isn’t a test for fibromyalgia, there are tests that can be done for other musculoskeletal system and connective tissue disorders to rule them out.

Body pain

Blood tests can be performed for diseases such as rheumatism, multiple sclerosis, and lupus. The laboratory findings can then help you and your doctor at least rule out certain disorders before determining what is causing your discomfort.

But… even if you’re able to get your doctor or health care provider to run these tests to rule out other disorders, that still doesn’t mean they are going to willingly give you a fibromyalgia diagnosis.

For so long, doctors haven’t taken fibromyalgia seriously.

They’ve seen it as a disorder that is more based on a person’s emotional state and may be linked to brain oversensitivity in how it processes pain, and not the actual pain itself.

A woman taking to a doctor

Though this is beginning to change in some medical communities, there is still not enough support for those unfortunate patients who continue to have to live with chronic pain while working fervently to get someone to give them a principal diagnosis of fibromyalgia.

For years, doctors and healthcare providers have believed that the symptoms of fibromyalgia are not consistent with an actual diagnosis of a specific disease.

Tender points tend to be symmetrical in the body and will radiate pain when a medical professional pushes their finger into the point. (This should be done with enough pressure to turn the top of a fingernail white when done.)

Getting a blood drawn out a body

How Can I Convince My Doctor to Use the Fibromyalgia ICD 10 Code Properly?

In order to finally get a diagnosis of your fibromyalgia, there are certain things you can do to help your doctor or health care provider understand the symptoms and how they are different than other soft tissue disorders.

First, have a conversation with your health care provider about the ICD 10 code for fibromyalgia.

You can remind them that in the ICD 10 CM booklet, the ICD 10 code for fibromyalgia is M 79.7 code.

Other soft tissue disorders have their own ICD 10 codes, but M 79.7 is the correct code for fibromyalgia.

Once you’ve looked up the code, ask your physician to spend some time reading over it together. Ask him or her to explain to you why they still aren’t convinced that your complaints don’t fall under the guidelines for a diagnosis of this disorder.

It’s not going to be easy, but if you continue to advocate for yourself, hopefully, you will eventually get the diagnosis you deserve.

Here at Native Formulas, we strive to do all we can to help you find the support you need and the products that can help alleviate some of your discomforts while you continue to find ways to live with your fibromyalgia.

None of us have to do it alone.


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